Delaying Cholecystectomy for Complicated Gallstone Disease in Pregnancy is Associated with Recurrent Postpartum Symptoms

Annapoorani Veerappan, Andrew J. Gawron, Nathaniel J. Soper, Rajesh N. Keswani

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Introduction: Pregnancy is a risk factor for gallstone disease; in some patients, cholecystectomy may be delayed to the postpartum period. Our aim was to examine the effect of antepartum interventions on postpartum outcomes in complicated gallstone disease (CGD) during pregnancy. Material and Methods: Retrospective analysis of patients seeking medical care for CGD (cholecystitis, choledocholithiasis, or gallstone pancreatitis) during pregnancy at a single tertiary care institution over a 10-year period (2002-2012). Patients were contacted via standardized telephone survey to account for outside hospitalizations. Results and Discussion: We identified 56 patients with CGD during pregnancy, 42.9 % initially presenting during the second trimester. Choledocholithiasis was the most common diagnosis (n = 30). Antepartum cholecystectomy was performed in 17.9 %. Seventeen patients did not follow up postpartum and did not complete telephone survey. Of the remaining 29 patients, 58.6 % had recurrent postpartum symptoms, 35.3 % recurred within 1 month, and 82.4 % within 3 months of delivery. Antepartum ERCP with biliary sphincterotomy decreased postpartum symptom recurrence (38.5 vs. 75.0 %, p = 0.07). Conclusions: The majority of patients with CGD who do not undergo antepartum cholecystectomy have recurrent postpartum symptoms often within 3 months postpartum. When appropriate, physicians should advocate for antepartum or early postpartum cholecystectomy to minimize symptom recurrence and unplanned hospitalizations.

Original languageEnglish (US)
Pages (from-to)1953-1959
Number of pages7
JournalJournal of Gastrointestinal Surgery
Issue number11
StatePublished - Nov 2013
Externally publishedYes


  • Biliary disease
  • ERCP
  • Postpartum complications
  • Pregnancy

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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