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Safety and Effectiveness of Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography in Biliary Pancreatitis During Pregnancy : BORN Study

Tarján, Dorottya ; Szalai, Eszter Ágnes ; Erőss, Bálint ; Hegyi, Péter Jenő ; Drug, Vasile Liviu ; Chooklin, Serge ; Hirth, Michael ; Sandblom, Gabriel LU ; Sandblom, Vanessa and Edergren, Åsa , et al. (2025) In United European Gastroenterology Journal 13(9). p.1803-1811
Abstract

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... (More)

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.

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type
Contribution to journal
publication status
published
subject
in
United European Gastroenterology Journal
volume
13
issue
9
pages
9 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:41045491
  • scopus:105018345288
ISSN
2050-6406
DOI
10.1002/ueg2.70121
language
English
LU publication?
yes
id
647bad5b-62cd-4b97-b50f-4885a378e54e
date added to LUP
2026-01-08 08:28:40
date last changed
2026-01-09 03:00:11
@article{647bad5b-62cd-4b97-b50f-4885a378e54e,
  abstract     = {{<p>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 &gt; 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 &gt; 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.</p>}},
  author       = {{Tarján, Dorottya and Szalai, Eszter Ágnes and Erőss, Bálint and Hegyi, Péter Jenő and Drug, Vasile Liviu and Chooklin, Serge and Hirth, Michael and Sandblom, Gabriel and Sandblom, Vanessa and Edergren, Åsa and Tlili, Ahmed and Fendri, Sami and Sirtl, Simon and de la Iglesia Gracía, Daniel and Kurti, Floreta and Wu, Dong and Gherbon, Adriana and Nawacki, Łukasz and Constantinescu, Alexandru and Shirinskaya, Natalia V. and Zolotov, Alexander N. and Pandanaboyana, Sanjay and Ikeura, Tsukasa and Cúrdia Gonçalves, Tiago and Rasmussen, Louise and Andersson, Bodil and Bouzid, Ahmed and Saidani, Ahmed and Ács, Nándor and Sipos, Zoltán and Farkas, Nelli and Tihanyi, Balázs and Teutsch, Brigitta and Nilsson, Johan and Mikó, Alexandra and Hegyi, Péter}},
  issn         = {{2050-6406}},
  language     = {{eng}},
  number       = {{9}},
  pages        = {{1803--1811}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{United European Gastroenterology Journal}},
  title        = {{Safety and Effectiveness of Cholecystectomy and Endoscopic Retrograde Cholangiopancreatography in Biliary Pancreatitis During Pregnancy : BORN Study}},
  url          = {{http://dx.doi.org/10.1002/ueg2.70121}},
  doi          = {{10.1002/ueg2.70121}},
  volume       = {{13}},
  year         = {{2025}},
}