Gut Liver.  2015 Sep;9(5):672-678. 10.5009/gnl14217.

Efficacy and Safety of Pancreatobiliary Endoscopic Procedures during Pregnancy

• Lee JJ
• Lee SK
• Kim SH
• Kim GH
• Park DH
• Lee S
• Seo D
• Kim MH

• KMID: 2234075
• DOI: http://doi.org/10.5009/gnl14217

Abstract

BACKGROUND/AIMS
Endoscopic therapy with endoscopic retrograde cholangiopancreatography (ERCP) has been suggested as an effective diagnostic and therapeutic tool for biliary and pancreatic disorders during pregnancy. In this report, we describe our experiences with pancreatobiliary endoscopic procedures during pregnancy.
METHODS
We reviewed ERCP and endoscopic ultrasonography (EUS) procedures that were performed at a single tertiary care referral center between January 2002 and October 2013. Medical records were reviewed for the procedure indication, the duration of fluoroscopy, postprocedure complications, etc. Pregnancy outcomes and fetal complications were identified by chart review and phone calls to patients.
RESULTS
A total of 10 ER-CPs and five EUSs were performed in 13 pregnant patients: four of whom underwent the procedure in the first trimester, eight in the second trimester, and one in the third trimester. Indications for endoscopic therapy included gallstone pancreatitis, obstructive jaundice with common bile duct (CBD) stone, asymptomatic CBD stone, pancreatic cyst, choledochal cyst, and acute cholecystitis. Only one patient had a complication, which was postprocedural hyperamylasemia. Two patients underwent an artificial abortion, one according to her own decision and the other due to an adverse drug reaction.
CONCLUSIONS
ERCP seems to be effective and safe for pregnant women. Additionally, EUS can be an alternative to ERCP during pregnancy.

Keyword

Cholangiopancreatography, endoscopic retrograde; Endosonography; Pregnancy; Fetus

MeSH Terms

Adult
Biliary Tract Diseases/*surgery
Cholangiopancreatography, Endoscopic Retrograde/*adverse effects/methods
Endosonography/*adverse effects/methods
Female
Fetus
Humans
Obstetric Surgical Procedures/*adverse effects/methods
Pancreatic Diseases/*surgery
Pregnancy
Pregnancy Complications/*surgery
Pregnancy Outcome
Retrospective Studies
Young Adult