Endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy in the management of acute cholangitis during pregnancy / 中华肝胆外科杂志

ABSTRACT

Objective To explore the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) in the management of acute cholangitis during pregnancy. Methods The clinical data of 16 pregnant patients with acute cholangitis who underwent ERCP and/or endoscopic sphincterotomy (EST) from August 2001 to February 2009 were retrospectively analyzed. Results Two patients were in the first trimester, 8 in the second trimester and 6 in the third trimester of pregnancy. Two patients had endoscopic placement of a plastic biliary stent in the first trimester. EST was then used to remove the stones successfully 4 and 5 months later. ERCP was performed in 8 women in the second trimester and 6 in their third trimester. Successful clearance of biliary stones at the time of ERCP was achieved in 14 pregnant women. Two patients who had multiple biliary stones underwent placement of a plastic biliary stent to limit the total fluoroscopy time. A second ERCP was carried out on the 2 patients to remove the stones after delivery. Post-ERCP mild pancreatitis developed in 1 patient in the third trimester. There was no spontaneous fetal loss, premature births, intrauterine fetal distress, fetal growth retardation/mental retardation/fetal malformation. Conclusion Short-term follow-up of all neonates whose mothers received ERCP during their pregnancies supported the efficacy and safety of its use. However, the long-term fetal complications of radiation exposure have not been investigated.