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Open Access 03-05-2024 | Appendicitis | SAGES/EAES Official Publication

SAGES guidelines for the use of laparoscopy during pregnancy

Authors: Sunjay S. Kumar, Amelia T. Collings, Claire Wunker, Dimitrios I. Athanasiadis, Colin G. DeLong, Julie S. Hong, Mohammed T. Ansari, Ahmed Abou-Setta, Emily Oliver, Vincenzo Berghella, Vamsi Alli, Imran Hassan, Celeste Hollands, Patricia Sylla, Bethany J. Slater, Francesco Palazzo

Published in: Surgical Endoscopy

Abstract

Background

When pregnant patients present with nonobstetric pathology, the physicians caring for them may be uncertain about the optimal management strategy. The aim of this guideline is to develop evidence-based recommendations for pregnant patients presenting with common surgical pathologies including appendicitis, biliary disease, and inflammatory bowel disease (IBD).

Methods

The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Guidelines Committee convened a working group to address these issues. The group generated five key questions and completed a systematic review and meta-analysis of the literature. An expert panel then met to form evidence-based recommendations according to the Grading of Recommendations Assessment, Development, and Evaluation approach. Expert opinion was utilized when the available evidence was deemed insufficient.

Results

The expert panel agreed on ten recommendations addressing the management of appendicitis, biliary disease, and IBD during pregnancy.

Conclusions

Conditional recommendations were made in favor of appendectomy over nonoperative treatment of appendicitis, laparoscopic appendectomy over open appendectomy, and laparoscopic cholecystectomy over nonoperative treatment of biliary disease and acute cholecystitis specifically. Based on expert opinion, the panel also suggested either operative or nonoperative treatment of biliary diseases other than acute cholecystitis in the third trimester, endoscopic retrograde cholangiopancreatography rather than common bile duct exploration for symptomatic choledocholithiasis, applying the same criteria for emergent surgical intervention in pregnant and non-pregnant IBD patients, utilizing an open rather than minimally invasive approach for pregnant patients requiring emergent surgical treatment of IBD, and managing pregnant patients with active IBD flares in a multidisciplinary fashion at centers with IBD expertise.

Graphical abstract

Available only for authorised users

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Title: SAGES guidelines for the use of laparoscopy during pregnancy
Authors: Sunjay S. Kumar
Amelia T. Collings
Claire Wunker
Dimitrios I. Athanasiadis
Colin G. DeLong
Julie S. Hong
Mohammed T. Ansari
Ahmed Abou-Setta
Emily Oliver
Vincenzo Berghella
Vamsi Alli
Imran Hassan
Celeste Hollands
Patricia Sylla
Bethany J. Slater
Francesco Palazzo
Publication date: 03-05-2024
Publisher: Springer US
Keywords: Appendicitis
Appendicitis
Chronic Inflammatory Bowel Disease
Cholecystectomy
Cholecystitis
Appendectomy
Endoscopic Retrograde Cholangiopancreatography
Choledocholithiasis
Expert Opinion
Expert Opinion
Published in: Surgical Endoscopy
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-024-10810-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

SAGES guidelines for the use of laparoscopy during pregnancy

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Graphical abstract

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