Laparoscopic Cholecystectomy Safe Throughout Pregnancy, finds study
A new study published in the BMC Surgery found that ultrasound diagnosis and laparoscopic cholecystectomy appear safe in all trimesters of pregnancy, with obstetric outcomes comparable to non-operative management. Surgery was also associated with a lower observed risk of venous thromboembolism (VTE), though evidence was limited. Further prospective studies are needed to refine patient selection and optimal surgical timing.
The study analysed 90 published studies spanning nearly six decades (1964–2023), including more than 160,000 pregnant patients across case reports, descriptive cohorts, and comparative studies. Evidence from PubMed, Web of Science, and Scopus databases were searched to assess clinical presentation, diagnostic approaches, treatment strategies, and maternal and fetal outcomes in pregnant women diagnosed with acute cholecystitis.
Among individual patient cases with reported symptoms, right upper quadrant abdominal pain was the most common presenting complaint, occurring in 40% of patients, followed by vomiting (33%), nausea (29%), and fever (17%). Ultrasound remained the primary diagnostic tool, most frequently identifying gallstones (42%) and ultrasonographic signs of cholecystitis or gallbladder wall thickening (21%).
Of the 93 patients with available treatment information, 81 underwent surgery, with laparoscopic cholecystectomy accounting for nearly 88% of operative procedures. Percutaneous gallbladder drainage was performed in a small number of patients, while open surgery was rarely required. Only 12 patients were managed conservatively without surgery.
Clinical outcomes were generally favourable, with 84% of reported cases experiencing uncomplicated recoveries. The pooled analysis also found no significant differences between operative and non-operative management in rates of caesarean delivery, preterm birth, postpartum hemorrhage, or overall pregnancy-related complications. Also, operative management was associated with a significantly lower risk of venous thromboembolism when compared to conservative treatment, reducing the relative risk by 45%.
Overall, the review suggests that ultrasound-based diagnosis combined with laparoscopic cholecystectomy can be safely performed throughout all stages of pregnancy when clinically indicated. The authors conclude that these findings support surgery as a viable treatment option without increasing adverse obstetric outcomes. Nevertheless, they emphasise the need for well-designed prospective studies to better define the optimal timing of surgery and identify which patients are most likely to benefit from operative intervention.
Source:
Kyrtsonis, G. K., Bobotis, S., Geropoulos, G., Triantafyllidis, K. K., Hassan, I. T., Vougiouklaki, E.-S., Galani, A., & Kechagias, K. S. (2026). Acute cholecystitis during pregnancy: a systematic review and meta-analysis. BMC Surgery. https://doi.org/10.1186/s12893-026-04087-5
