BILIARY TRACT DISEASE IN PREGNANCY

Abstract

Cholelithiasis is a common biliary tract disease in the United States, and more than 75% of the gallstones are composed of cholesterol. 17 There is considerable evidence that pregnancy is a predisposing factor in the formation of cholesterol gallstones. Sex steroids cause an alteration in biliary lipid composition and gallbladder motility leading to an increase in cholesterol gallstone synthesis. Gallstone disease is observed in 3.3% to 12.2% of pregnant women. 9,53,79,88 Complications of gallstones represent the second most common nongynecological condition requiring surgery in pregnancy 89 ; yet, clinically apparent disease is rare. The management of symptomatic gallstone disease during pregnancy is controversial. It is important for clinicians caring for pregnant patients to recognize the signs and symptoms of biliary tract disease during pregnancy and understand the management options.