Önder SÜRGİT, Zeynep KAMALAK, İlknur İnegöl GÜMÜŞ, Nilgün Öztürk TURHAN

Aynı cerrahi seansta sezaryen sonrası laparoskopik kolesistektomi

Gebelik fizyolojik bir süreç olmakla beraber birçok sistemde değişiklikler meydana gelmektedir. Gebelikte safra kanallarında safra asitlerinin akımında da yavaşlama meydana gelmekte ve gebelik kolestazı ve safra kesesi taşı ile sonuçlanabilmektedir. Bu gibi değişimler gebelik sürecinde maternal ve fetal riskleri artırmaktadır. Cerrahi müdahele gerekliliğinde özellikle ikinci trimester tercih edilmektedir. Nitekim ikinci trimesterde cerrahiye ve anesteziye bağlı riskler minimal olmaktadır. Kolelitiazis ve safra kesesi taşları için laparoskopi goldstandart yaklaşım olup gebelikte de tercih edilmektedir. Biz bu vaka takdiminde ikinci trimesterde kolelitiazis ve safra çamuru bulunan bir gebenin sezaryen ile doğumundan hemen sonra tek bir anestezi ile sezaryen insizyonunun kapatılmasını takiben laparoskopik kolesistektomisini ele aldık. İkinci trimester cerrahi müdahale mümkün olmakla beraber sezaryen ile doğum yapacak bir gebede cerrahi, hastanın durumu stabil ise doğum sonrasına da ertelenebilir.

Laparoscopic cholecystectomy following cesarian section in the same surgery session

Although pregnancy is a physiologic process, there are a lot of modification in many systems. Biliary stasis occurs in biliary ducts during pregnancy and this situation results in gallstones and intrahepatic cholestasis of pregnancy. There are maternal and fetal complications associated with these changes. If surgery is indicated, second trimester is the most reasonable time. In fact, the risks of the anesthesia and surgery are minimal in second trimester. Laparoscopic cholecystectomy is the gold standart treatment for cholelithiasis and gallbladder stones. In this case report we presented a pregnant woman with gallbladder stone, having laparoscopic cholecystectomy just after caserian section in the same anesthesia. Surgery can be appropriate in second trimester but if the patients’ condition is stable, it can be performed just after the delivery.

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