Q. As I have gallstones, is it mandatory to undergo cholecystectomy before planning pregnancy?

Answered by
Dr. A V Hussain Shihaz
and medically reviewed by Dr. Nithila A
Published on May 11, 2019

Hello doctor,

I am a 34-year-old female ophthalmologist. I have a single gallstone which is 10 mm in size that was noticed incidentally in ultrasound. Is it necessary to undergo cholecystectomy before planning my second pregnancy? I had nonspecific episodes of abdominal pain in the last two years which were not typical of gallbladder pain because the pain was more located in the center and lower abdomen. But the intensity of the pain was severe and was associated with nausea, and vomiting which relieved only after taking intramuscular painkillers.

Dr. A V Hussain Shihaz

Medical Gastroenterology
#

Hello,

Welcome to icliniq.com.

I have gone through your case and reports (attachment removed to protect patient identity). This looks like a symptomatic uncomplicated gallbladder stones. Even though you say that the symptoms have not been typical of biliary colic but the repeated episodes of pain, need for parenteral analgesics, and no other attributable cause leads to consider gallbladder stones as the cause for your pain.

Without surgery, there is 50 % chance of recurrent pain episodes per year, 2 % chance of biliary complications per year, and 30 % will have no further pain if there was only one episode of biliary pain previously. The best option in this situation is laparoscopic cholecystectomy especially if you are planning a pregnancy. Since during pregnancy, the risk of recurrent pain and complications are higher.

The other issue is that risk of surgery in the first and third trimester is significantly higher with the preferable period for surgery in pregnancy being the second trimester. You can consider medical dissolution therapy of gallstones but the efficacy is 30 to 49 %. And this is mainly based on the unimpaired motor activity of gallbladder, which has to be assessed before therapy (only with good motor activity of gallbladder the efficacy of 30 to 49 % can be predicted). The best option in your case is laparoscopic cholecystectomy.

Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers


Do I need to get treatment for 3 mm gallbladder stone?

Query: Hi doctor, I am feeling nauseous in the morning hours for about a month. But, I vomit only once a day. My blood test report is normal, but there is a slight increase in eosinophil count (9.8). I am also found with a 3 mm gallbladder stone. My age is 40 years. I am currently on Pantocid and Domstal ...  Read Full »

Pregnancy and Birth

Article Overview: Pregnancy is the time taken for a fetus to develop inside a woman’s womb. Sometimes, if more than one embryo develops inside the uterus at the same time, it is known as a multiple pregnancy.  Read Article


Dr. Shruti Kainth Kaushal
Obstetrician And Gynaecologist

Overview: Pregnancy is the time taken for a fetus to develop inside a woman’s womb. Sometimes, if more than one embryo develops inside the uterus at the same time, it is known as a multiple pregnancy. It typically lasts for 40 weeks from the last menstrual period (LMP). A woman can get pregna...  Read Article

Pregnancy test had two mildly visible lines, but it is now negative.

Query: Hello doctor, I had unprotected sex six weeks ago and my period was late for two weeks. I used the first PT when my period was five days late and it has two lines but it is not that visible. After three days, I tried again and it is already negative. Up to the two-weeks late period, all PT are negat...  Read Full »

Popular

Popular

Ask your health query to a doctor online?

Ask a Medical Gastroenterologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.

Fee:  

 


Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.