Objectives: This prospective study aimed to evaluate the surgical outcome of elective
laparoscopic cholecystectomy (LC) during elective cesarean section (CS) for full-term
• pregnant women under medical control for previous acute biliary conditions (ABC)
during pregnancy.
Patients & Methods: The study included 35 parturient assigned for elective CS and had
recurrent attacks of ABC throughout the course of pregnancy and were under medical
control (Study group) and another 35 parturient assigned for CS for the same indications
and are free of ABC (Control group). In study group, after closure of the uterus the
supraumblical trochar was inserted under-vision then peritoneal water-seal closure was
performed and a standard four ports LC was performed according to the European "fourpuncture"
technique.
Io
esults: All patients passed smooth intraoperative course without complications or
onversion to open cholecystectomy in study group. Mean operative time for CS only in
ntrol group was 41.4±9.6; range: 25-55 minutes and was non-significantly shorter than
the total operative time for the combined procedures of 49.5±I0.3; range: 35-80 minutes.
Mean time till first ambulation, mean time for first oral intake and mean duration of
hospital stay showed non- significant variance among studied groups. Seven patients had
mild CS wound infection and were managed conservatively.
Conclusion: Combined CS and LC in the same-setting are feasible and safe with
operative times and hospital stay were in acceptable ranges for CS alone without
'additional burden of pain or morbidities. It is recommended as a therapeutic modality for
pregnant women had recurrent attacks of ABC during pregnancy and assigned for CS.
Keywords: laparoscopic cholecystectomy, cesarean section, same-setting |
