ﮔﺰارش ﯾﮏ ﻣﻮرد ﮐﻮﻟﻪ ﺳﯿﺴﺘﮑﺘﻮﻣﯽ ﻻﭘﺎروﺳﮑﻮﭘﯿﮏ ﻣﺸﮑﻞ در ﻫﻔﺘﻪ 34 ﺑﺎرداري

Report of a Case of Difficult Cholecystectomy in a 34th Gestational age of Pregnancy

درﻣﺎن اورژاﻧﺲﻫﺎي ﺷﮑﻤـﯽ از ﺟﻤﻠﻪ ﮐﻮﻟﻪ ﺳﯿﺴﺘﯿـﺖ ﺣﺎد در زﻧﺎن ﺑﺎردار ﻫﻤـﻮاره ﭼﺎﻟـﺶ ﺑﺮاﻧﮕﯿـﺰ ﺑﻮده اﺳﺖ. اﮔـﺮﭼﻪ در ﺳﺎلﻫﺎي اﺧﯿـﺮ ﺑﺎ ﭘﯿﺸـﺮﻓﺖﻫﺎي ﺑﻪ دﺳﺖ آﻣـﺪه، ﻻﭘﺎروﺳﮑـﻮﭘﯽ در درﻣـﺎن اﯾﻦ ﺑﯿﻤـﺎران ﺑﺴﯿـﺎر ﻣﻮرد ﺗﻮﺟﻪ ﻗﺮار ﮔﺮﻓﺘﻪ اﺳﺖ، اﻣﺎ ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﺗﻐﯿﯿﺮات ﻓﯿﺰﯾﻮﻟـﻮژﯾﮏ و آﻧﺎﺗﻮﻣﯿـﮏ ﺑﺪن زﻧﺎن ﺑﺎردار، ﺑﺴﯿﺎري از ﺟﺮاﺣﺎن از اﻧﺠﺎم ﮐﻮﻟﻪ ﺳﯿﺴﺘﮑﺘﻮﻣﯽ ﻻﭘﺎروﺳﮑﻮﭘﯿﮏ [Laparoscopic Cholecystectomy (LC)] در ﺳﻨﯿﻦ ﺑﺎﻻي ﺑﺎرداري ﻧﮕﺮاﻧﻨﺪ. ﻣﺎ در اﯾﻦ ﻣﻘﺎﻟﻪ ﺑﻪ ﻣﻌﺮﻓﯽ ﯾﮏ ﺑﯿﻤﺎر ﭘﺮداﺧﺘﯿﻢ ﮐﻪ در ﻫﻔﺘﻪ 34 ﺑﺎرداري ﺑﺎ ﭘﺎﻧﮑﺮاﺗﯿﺖ و ﮐﻮﻟﻪ ﺳﯿﺴﺘﯿﺖ ﺣﺎد ﻣﺮاﺟﻌﻪ ﻧﻤﻮد و ﭘﺲ از درﻣﺎن داروﯾﯽ ﺑﺮاي ﭘﺎﻧﮑﺮاﺗﯿﺖ، ﺗﺤﺖ LC ﺑﺮاي درﻣﺎن ﮐﻮﻟﻪ ﺳﯿﺴﺘﺴﺖ ﻗﺮار ﮔﺮﻓﺖ و در ﺣﺎل ﺣﺎﺿﺮ ﭘﺲ از 3 ﺳﺎل، ﺣﺎل ﻋﻤﻮﻣﯽ ﻣﺎدر و ﮐﻮدك ﮐﺎﻣﻼً اﯾﺪهآل اﺳﺖ.

Treatment of acute abdomen including acute cholecystitis in pregnant women has been controversial. Although recent advances had resulted in increasing use of laparoscopic procedures in these patients, however, based on anatomical and physiological changes in pregnancy, many surgeons are concern with laparoscopic cholecystectomy (LC) in high gestational age. In current manuscript, we report a 25 years old pregnant female with acute cholecystitis and pancreatitis at 34 weeks of gestational age underwent medical treatment for pancreatitis followed by LC. The general status of the mother and infant are satisfying after 3 years follow up.