Gall Bladder Polyp in young pregnant woman - Forum

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Arizona

Gall Bladder Polyp in young pregnant woman - Ärzteforum

Post#1 »

Your opinions please regarding a 28 year old pregnant woman whose EDC is 5/10. About 3 weeks ago she had a single episode of abdominal pain. It was not particularly typical for biliary - was low to mid abdomen - really along the right lateral uterus. Normal liver enzymes and bilirubin.

The family doc got an ultrasound which showed a 2.6 cm polyp (actually the length of the stalk and the greatest diameter). Follow-up ultrasound now shows no change in the size of the polyps. Bile ducts are normal on both studies. She has not had any more pain.

My inclination is to do a lap chole after she delivers.

Does anyone believe that the risk of a significant neoplasm is sufficiently high to justify urgent operation? When the operation is done can it be a standard subserosal dissection, extra serosal (lap or open?) or should it include adjacent liver resection?


bonjorno

Re: Gall Bladder Polyp in young pregnant woman - Ärzteforum

Post#2 »

Let get deliver her child in peace and after,proceed to Lap Chole...It's mandatory.

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Surgeon

Re: Gall Bladder Polyp in young pregnant woman - Ärzteforum

Post#3 »

I agree, a couple of months delay won't make a difference. Certainly your research indicates you are on the right track.

Paranoid

Re: Gall Bladder Polyp in young pregnant woman - Ärzteforum

Post#4 »

My advice is this: wait for the delivery and after the recovery do a LC, send the GB to biopsy and depending on the result you may convert and do a liver resection. Remember, take the GB out in a bag.

forceps

Re: Gall Bladder Polyp in young pregnant woman - Ärzteforum

Post#5 »

I would advise an open cholelcystectomy after she delivers...there is no urgency. The lesion should be considered premalignant. If then there is even a slight chance of malignancy now, disruption of the gb wall that happens not infrequently during lap chol would allow for dissemination of cells, very possibly to the trocar sites. Open op would prevent this.

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