Features of pathogenesis, diagnostics and treatment of gallstone disease at pregnancy

Abstract

The aim of review. To highlight the modern concept of the gallstone disease (GSD) pathogenesis at pregnancy and to discuss modern diagnostic and treatment approaches. Summary. The risk of biliary sludge and cholesterol gallstones at pregnancy is significantly increased that is caused mainly due to elevation of estrogen and progesterone level leading to increased cholesterol synthesis, decreased gallbladder contractility and, as a result, to increased lithogenicity of bile. Clinical presentation of GSD at pregnant patients is similar to that at nonpregnant women. Transabdominal ultrasound investigation play the major role in diagnosis of cholelithiasis at pregnancy. For treatment of symptomatic GSD forms in this the period active surgical approach is becoming more and more common. Laparoscopic cholecystectomy is a method of choice, and the optimal term for its implementation is the second trimester of pregnancy. Prevention and treatment of biliary sludge in pregnancy may be carried out by ursodeoxycholic acid. Conclusion. Increased risk of cholelithiasis at pregnant women requires further improvement of management approach and search for better methods for treatment and prophylaxis

Keywords

• желчнокаменная болезнь
• беременность
• диагностика
• лечение