妊娠26週で腹腔鏡下胆嚢摘出術を施行した1例

A Case of Laparoscopic Cholecystectomy During The 26th Week of Pregnancy

　われわれは疝痛発作を繰り返す胆嚢腺筋症の妊婦に対し，腹腔鏡下胆嚢摘出術を施行した．症例は29歳，女性で，妊娠後早期から右季肋部痛を認め，近医にて胆石症，胆嚢炎と診断され，当院に紹介され入院となった．保存的療法で経過をみるも改善せず，経口摂取もできない状態となったため，妊娠26週に手術を施行した．手術は全身麻酔下に，炭酸ガス気腹法を用いて行った．術中，母子ともに異常は認めなかった．術後軽度の子宮収縮を認めたが胎児に異常はなく，退院後妊娠40週で健常男児を出産した．近年，妊婦に対して腹腔鏡下胆嚢摘出術を施行した報告がみられるようになり，妊婦に対しても安全に行える術式であることが示唆された．

We report a case of laparoscopic cholecystectomy performed on a pregnant woman with a repeated attack of cholecystolithiasis due to adenomyomatosis. The patient was a 29-year-old female who complained of right hypochondralgia after pregnancy. She was diagnosed as cholecystolithiasis, and was sent to our hospital. Because her condition did not improve with conservative therapy, we performed the operation at 26 weeks of gestation. The operation was performed with the use of CO₂pneumoperitoneum under general anesthesia, and no abnormal effects appeared in the patient and her fetus.