COMBINED LAPAROSCOPIC CHOLECYSTECTOMY AND CAESARIAN SECTION: SAFETY AND FEASIBILITY.

Abstract

INTRODUCTION: Cholelithiasis is quite common in women of child bearing age. We planned a study to evaluate the safety of combined laparoscopic cholecystectomy and lower segment caesarean section (LSCS). AIMS AND OBJECTIVES: To study feasibility and safety of cholecystectomy at the time of caesarean section. MATERIALS AND METHODS: This was a prospective hospital based observational study and included 50 consecutive pregnant females who underwent a combined LSCS and were having symptomatic cholelithiasis. Patient demographics and a detailed history was taken. After completing LSCS, the rectus sheath was closed and a standard four port laparoscopic cholecystectomy was performed. Intraoperative parameters and postoperative morbidity were
noted.
RESULTS: Laparoscopic cholecystectomy was combined with LSCS under general anesthesia in all the patients. The mean age of patients was 32.28 + 4.67 years. Surgeries were completed in a mean operating time of 78.54 + 15.21minutes. There were no intraoperative or major postoperative complications. No extra antibiotics or analgesics doses were needed. Most
of the patients were discharged on the third postoperative day.
CONCLUSION: In addition to being safe and effective, a combination technique of laparoscopic cholecystectomy with LSCS provides the benefits of minimal access surgery for gallstone disease. Apart from minimising the separation of mother and newborn caused by
reoperation, it also reduces the risk of developing acute cholecystitis while the patient is waiting for cholecystectomy.