Acute biliary pancreatitis in pregnancy: Ten year retrospective study

Abstract

Introduction: The prevalence of pregnancy-related acute biliary pancreatitis (ABPP) is not infrequent especially in the third trimester. Timely intervention of ABPP will reduce the maternal and fetal morbidity and mortality. Methods: A single center retrospective study was carried out. Randomly selected 1000 medical records of the pregnant mothers who were hospitalized from 2012 to 2022 were retrieved. Selection of patients who had ABPP were done according to exclusion and inclusion criteria. The following parameters were reviewed: the patient’s age, pregnancy trimester, ABPP severity, risk factors for ABPP, imaging modalities, biochemical tests, treatment methods, length of hospital stay (LOS), and maternal or fetal morbidity and mortality. Ethical approval was granted by Nawaloka Hospital Research and Education Foundation. No conflict of interest. Results: In total of 7 with ABPP were identified [0.7% (7/1000)]. Epigastric pain was the main complaint of all ABPP patients. Biliary pathology were detected in abdominal ultra sonography (USG). Majority were in the third trimester [57.1% (4/7)]. The mean age of the patients was 27.6±5.3 (range, 18-44) years. The most of the women were multiparous [71.4%(5/7)]. Out of 7 patients 4 (57.1%) had mild symptoms and 3 (42.8%) had moderate symptoms of pancreatitis. The mean length of hospital stay (LOS) was 4.6±1.5 (range, 3-7) days. All patients were conservatively managed. None reported with a recurrent episode of ABPP during pregnancy. 5 (71.4%) patients in the pregnant group underwent planned laparoscopic cholecystectomy (LC) in the first 6 to 12 months after delivery. Conclusion: This study sample highlighted that mild to moderate ABPP can be managed with conservative treatment. The recurrence and their severity are unpredictable. Therefore following initial management, early cholecystectomy can be considered as a treatment modality. To generalize these findings further studies are recommended.