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

Hello,

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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.