Pregnant Women Should Delay Gallbladder Surgery, Study Finds

Expectant mothers are susceptible to developing gallstones, but gallbladder removal surgery during pregnancy can be risky, researchers say.

In a new study, researchers found that women who had their gallbladder removed during pregnancy were more likely to have a longer hospital stay and be readmitted within a month. These women were also more likely to have a preterm delivery compared with women who postponed the surgery until after childbirth.

"In light of these findings, whenever possible, women with symptomatic gallstones in pregnancy should wait as long as possible to let the baby mature before having the [gallbladder removal surgery]," said study co-author Dr. Henry Pitt. He is a professor of surgery at Temple University School of Medicine in Philadelphia.

Using a California database, Pitt's team collected data on 403 pregnant women who had the operation in the 90 days before childbirth, and nearly 17,500 women who had the procedure in the three months after childbirth, between 2005 and 2014.

After a minimally invasive gallbladder surgery, most patients can go home the same day. When pregnant women had the procedure, however, 85 percent needed to be hospitalized. And 13 percent of pregnant women needed to have an open operation, compared with 2 percent of women who were not pregnant, the findings showed.

Complications of pregnancy -- such as eclampsia (seizures), bleeding and preterm delivery -- were much worse for women who had gallbladder surgery during pregnancy, Pitt said in a news release from the American College of Surgeons.

Women who had the operation during the third trimester were twice as likely to deliver a preterm infant, the researchers said.

"The real significant finding is that babies were being born preterm when they weren't adequately developed. And we know that preterm delivery is associated with neonatal mortality and multiple adverse outcomes for the baby," Pitt said. "So that is the real reason to wait: to make sure the outcome for the baby is the best possible outcome."

Women who had the gallbladder surgery in the third trimester often stayed in the hospital longer (three days versus one day), incurred more costs (nearly $20,000 versus $17,500), and had higher 30-day readmission rates (10 percent versus 4 percent) than women who waited for their operation until after they gave birth, the study authors said.

The report was published online recently in the Journal of the American College of Surgeons.

Right now, guidelines from the Society of American Gastrointestinal and Endoscopic Surgeons recommend the procedure for all pregnant women with symptomatic gallstones and suggest that the procedure is safe for both the mother and baby, according to the news release.

Pitt thinks that these findings call for a change in the guidelines.

The study did find, however, that 98 percent of the time, the procedure was being done after delivery, Pitt noted.

"So, despite the recommendations in these guidelines, I think surgeons and obstetricians knew that the better approach for the patient was to wait as long as possible," he said.

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