ERCP in acute cholangitis during third trimester of pregnancy

摘要

Background/Aims: To explore the efficacy and safety of modified endoscopic retrograde cholangiopancreatographies (ERCP) management of acute cholangitis during the third trimester of pregnancy. Methodology: Seventeen pregnancy women who were diagnosed as acute cholangitis during their third trimester and received modified ERCP between January 2000 and January 2012 in our solo medical center, were included in this study. All cases received two-stage interventions: 7 cases had caesarean birth in one week with endoscopic nasobiliary drainage (ENBD) after the first ERCP, and cleaned their bile ducts by second ERCP 1 week postpartum; 10 cases received endoscopic retrograde biliary drainage (ERBD) by bile duct plastic stents, and took out stents and stones by second ERCPs between 2 weeks and 1 month after termination of pregnancy. Results: The complication rate was 5.88% (2/34) in all 34 ERCPs on 17 cases (one biliary tract hemorrhage and one case of acute mild pancreatitis). All clinical symptoms were significantly alleviated; 11 cases had term labors and 6 cases had premature delivery. All 18 babies were healthy in follow-up 3 months postpartum. Conclusions: Modified ERCP is a safe procedure for acute cholangitis in pregnant women during the third trimester.