A case of laparoscopic cholecystectomy for acute cholecystitis in 34th week of gestation Kai CHEN 1 , Yoshio NAGAHISA 1 , Kazuki HASHIDA 1 , Mitsuru YOKOTA 1 , Michio OKABE 1 , Kazuyuki KAWAMOTO 1 1Department of General Surgery, Kurashiki Central Hospital Keyword: 妊娠 , 腹腔鏡下胆囊摘出術 , 胆囊炎 pp.44-50
Published Date 2019/1/15
DOI https://doi.org/10.11477/mf.4426200664
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 A 27-year-old pregnant woman, who had suffered from constant right hypochondralgia, came to the emergency department at 34 weeks and 4 days of gestation. She was diagnosed as having acute cholecystitis and underwent laparoscopic cholecystectomy. The postoperative course was good and uneventful for both the mother and the fetus with no complications. As uterus usually rises up to the head side in the 3rd trimester, in order to prevent uterus injuries, it is important to examine the position of the fundus of uterus by ultrasound beforehand, and to insert the first trocar in the upper abdomen by open method using a 5mm flexible scope. Moreover, attention should be made on ventilation because gravid uterus elevates the diaphragm and intubation tube may go deeper than expected. In Japan, only a few cases of laparoscopic cholecystectomy in the 3rd trimester have been reported so far. We were able to perform laparoscopic cholecystectomy in the 3rd trimester safely with various ideas and efforts.

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