TOPLINE:

Cholecystectomy during the second or third trimester of pregnancy was safe and effective in preventing recurrent biliary events in women with mild biliary acute pancreatitis (AP). Endoscopic retrograde cholangiopancreatography (ERCP) was safe across all trimesters.

METHODOLOGY:

• Cholecystectomy is considered safe and may reduce readmissions, but its optimal timing remains uncertain, leading clinicians to often hesitate before performing the procedure during pregnancy.
• Researchers conducted an international retrospective multicentre cohort study to assess the safety and efficacy of cholecystectomy and ERCP in pregnant women with biliary AP.
• Overall, 101 pregnant women with biliary AP who had received treatment since January 2011 were included. Of these, the majority (86%) had mild AP, and 9% and 5% had moderate and severe AP, respectively.

TAKEAWAY:

• None of the participants in the cholecystectomy group vs 24% of those in the non‑cholecystectomy group were readmitted for biliary complications within 1 year, whose readmissions were mainly due to recurrent AP, cholecystitis, or cholangitis.
• The preterm birth rate did not differ significantly between the cholecystectomy and non‑cholecystectomy groups. Foetal loss was marginally higher in the cholecystectomy group than in the non‑cholecystectomy group (18% vs 2%; P = .050); all losses occurred when the procedure was performed during the first trimester.
• Rates of readmission, foetal loss, and preterm birth were not different between participants who underwent ERCP during pregnancy and those who did not.
• Rates of readmission, preterm birth, and foetal mortality were similar between ERCP and cholecystectomy performed during pregnancy.

IN PRACTICE:

"In cases of mild biliary AP during pregnancy, cholecystectomy can be performed in the second and third trimesters, and ERCP can be safely performed during any trimester," the authors wrote.

SOURCE:

This study was led by Dorottya Tarján, Centre for Translational Medicine, Semmelweis University, Budapest, Hungary. It was published online on October 04, 2025, in United European Gastroenterology Journal.

LIMITATIONS:

Because the study was retrospective, confounders such as comorbidities, socioeconomic status, nutrition, anaesthesia techniques, and obstetric management strategies may not have been captured. The international multicentre design introduced variability in surgical timing, ERCP protocols, and obstetric supportive care, which may have affected outcomes. This study did not assess long-term developmental outcomes.

DISCLOSURES:

This study was supported by the Hungarian Ministry of Innovation and Technology and National Research, Development and Innovation Fund. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.