| 論文種別 | 原著(症例報告除く) |
| 言語種別 | 英語 |
| 査読の有無 | その他(不明) |
| 表題 | Safety and Effectiveness of Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography in Biliary Pancreatitis During Pregnancy: BORN Study. |
| 掲載誌名 | 正式名：United European gastroenterology journal 略 称：United European Gastroenterol J ISSNコード：20506414/20506406 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 13(9),pp.1803-1811 |
| 著者・共著者 | Dorottya Tarján, Eszter Ágnes Szalai, Bálint Erőss, Péter Jenő Hegyi, Vasile Liviu Drug, Serge Chooklin, Michael Hirth, Gabriel Sandblom, Vanessa Sandblom, Åsa Edergren, Ahmed Tlili, Sami Fendri, Simon Sirtl, Daniel de la Iglesia Gracía, Floreta Kurti, Dong Wu, Adriana Gherbon, Łukasz Nawacki, Alexandru Constantinescu, Natalia V Shirinskaya, Alexander N Zolotov, Sanjay Pandanaboyana, Tsukasa Ikeura, Tiago Cúrdia Gonçalves, Louise Rasmussen, Bodil Andersson, Ahmed Bouzid, Ahmed Saidani, Nándor Ács, Zoltán Sipos, Nelli Farkas, Balázs Tihanyi, Brigitta Teutsch, Johan Nilsson, Alexandra Mikó, Péter Hegyi |
| 発行年月 | 2025/11 |
| 概要 | BACKGROUND:Biliary acute pancreatitis (AP) during pregnancy is a challenging situation, and current guidelines for AP, pregnancy care, and surgery do not specifically address its management. This study investigated the safety and effectiveness of cholecystectomy and endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy in AP.METHODS:This international retrospective multicenter cohort study encompassed questions related to demographic information, clinical presentation, management strategies, timing of cholecystectomy, approaches to the procedure, complications, and outcomes. Continuous variables were summarized as medians with interquartile ranges, and categorical variables as frequencies and percentages. Group comparisons used Welch's t-test, Pearson's chi-squared, or Fisher's exact tests.RESULTS:A total of 101 cases from 14 countries and 19 centers were enrolled. Cholecystectomy after mild AP during pregnancy had a lower rate of readmission due to recurrent AP or other gallstone-related complications compared with those who did not undergo surgery after a mild AP during pregnancy (0% vs. 24%; n = 0/17 vs. n = 12/49, p = 0.027). Cholecystectomy performed during pregnancy was associated with a low surgical complication rate, identical to that seen in postpartum procedures (12% vs. 10%; n = 2/17 vs. n = 3/30; p > 0.999). Preterm birth occurred in 7.1% (n = 1/14) of patients with cholecystectomy versus 11% (n = 5/45) without. Fetal loss after surgery occurred only in the first trimester (n = 3/17 vs. n = 1/49). No difference was seen in readmission (5%, n = 1/21 vs. 27%, n = 4/15; p = 0.138), fetal loss (5%, n = 1/21 vs. 27%, n = 4/15; p = 0.138) and preterm birth (6%, n = 1/17 vs. 8%, n = 1/12; p > 0.999) between the surgical and ERCP groups. The fetal loss (9.1%, n = 2/22 vs. 5.4%, n = 4/74; p = 0.618) and preterm birth rates (5.9%, n = 1/17 vs. 12%, n = 8/65; p = 0.677) did not significantly differ between patients with and without ERCP during pregnancy.CONCLUSION:Cholecystectomy is effective and safe in pregnant patients during the second or third trimester in cases of mild biliary pancreatitis. ERCP is safe in any trimester. |
| DOI | 10.1002/ueg2.70121 |
| PMID | 41045491 |