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Gallsteinasjúkdómar hjá þunguðum konum á Landspítala 1990-2010

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Authors
Hörður Már Kolbeinsson
Hildur Harðardóttir

Guðjón Birgisson
Páll Helgi Möller
Issue Date
2016

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Other Titles
Gallstone disease during pregnancy at Landspitali University Hospital 1990-2010
Citation
Læknablaðið 2016, 102(12):
Abstract
Inngangur: Gallblöðrutaka um kviðsjá er talin örugg aðgerð á meðgöngu, óháð meðgöngulengd. Ekki er vitað hver kjörmeðferð er við gallsteinasjúkdómum hjá þunguðum konum. Talið hefur verið að meðferð án aðgerðar skili bestum árangri á fyrsta og þriðja þriðjungi meðgöngu en skurðmeðferð sé öruggust á öðrum þriðjungi. Tilgangur rannsóknarinnar var að kanna tíðni, orsakir, greiningu og árangur gallblöðrutöku hjá þunguðum konum á Landspítala á tímabilinu 1990-2010. Efniviður og aðferðir: Rannsóknin var afturskyggn og tók til allra kvenna er lögðust inn á Landspítala með gallsteinasjúkdóm meðan á þungun stóð og allt að 6 vikum eftir fæðingu. Skráðar voru meðal annars upplýsingar um aldur, einkenni, vefjagreiningu og þyngdarstuðul ásamt ASA-flokkun og fylgikvillum aðgerða hjá þeim konum sem gengust undir gallblöðrutöku á tímabili rannsóknarinnar. Niðurstöður: Á rannsóknartímabilinu voru 77 konur lagðar inn með gallsteinasjúkdóma í samtals 139 innlögnum og nýgengi því 0,09%. Gallsteinagreiningar voru gallkveisa (n=59), brisbólga (n=1), gallgangasteinar (n=10) og bráð gallblöðrubólga (n=7). Algengasta ástæða innlagnar var verkur í efri hægri fjórðungi kviðar (n=63). Fylgikvillar gallsteinasjúkdóma tengdir meðgöngu voru fyrirburafæðingar (n=2). Fimmtán konur gengust undir aðgerð á meðgöngu og 17 á 6 vikna tímabili eftir fæðingu en fylgikvillar aðgerða voru helst steinar í gallgangi (n=2). Meðal þyngdarstuðull sjúklinga var 31,1 og algengasta ASA-flokkun var 1 (bil: 1-3). Flest vefjasvör sýndu langvinna bólgu (n=24) og bráða bólgu (n=5) í gallblöðru. Ályktun: Gallsteinasjúkdómar þungaðra kvenna eru fátíðir, hafa í för með sér endurteknar innlagnir en tíðni fylgikvilla er lág. Gallblöðrutaka með kviðsjá hjá þunguðum konum á Landspítala er örugg aðgerð, sem er í samræmi við erlendar niðurstöður.
Introduction: Gallstone disease in pregnant patients and their management in Iceland has not been studied. Management of these patients changed after the introduction of laparoscopic cholecystectomy. The aim of this study was to investigate the incidence, symptoms, diagnostic methods and management of gallstone disease during pregnancy at the National University Hospital of Iceland during the years 1990-2010. Material and methods: This was a retrospective study and included all pregnant women admitted with gallstone diseases to the National University Hospital of Iceland which is the only tertiary hospital in Iceland. Information regarding age, symptoms and diagnostic methods for all women with gallstone disease along with BMI, ASA scores, pathology results and pregnancy related outcomes for women who underwent cholecystectomy were gathered. Results: During the twenty year time period 77 women were admitted with gallstone disease in 139 admissions which makes incidence 0,1% amongst pregnant women. Diagnoses incuded biliary colic (n=59), common bile duct stones (n=10), acute cholecystitis (n=7) and gallstone pancreatitis (n=1). The most common symptom was RUQ pain (n=63). Two preterm births were a direct consequence of gallstone disease. Fifteen women underwent cholecystectomy during pregnancy and 17 during the six week period after birth. Mean BMI was 31,1 and median ASA score was 1. Pathology reports showed chronic inflammation (n=24) and acute inflammation (n=5), one case included gallstones without inflammation Adverse outcomes of surgeries were two cases of gallstones left in the common bile duct. No stillbirths or preterm births resulted from cholecystectomies during pregnancy. Conclusion: Gallstone disease during pregnancy is rare and readmissions are frequent. Pregnancy related complications are rare. Laparoscopic cholecystectomy is safe during pregnancy.
Description
Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn
Additional Links
http://www.laeknabladid.is/
http://dx.doi.org/10.17992/lbl.2016.12.110
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openAccess
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Icelandic Journal Articles (Peer Reviewed)

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