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Comment & Response
April 28, 2021

Nonoperative Management for Pregnant Individuals With Gallstone Disease in the Third Trimester—Reply

Author Affiliations
  • 1Division of Trauma and Critical Care, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Section of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, Connecticut
JAMA Surg. 2021;156(8):796-797. doi:10.1001/jamasurg.2021.0643

In Reply We appreciate the interest in our work1 and the perspective presented by Fong and colleagues. Specifically, they raise concern with our recommendation to offer cholecystectomy to pregnant patients with symptomatic gallstone disease regardless of pregnancy trimester, particularly with regard to those in the third trimester. They refer us to their 2019 study comparing women who underwent cholecystectomy during the third trimester with those who underwent cholecystectomy within 3 months post partum.2 They queried the California Office of Statewide Health Planning and Development database to assess cholecystectomy-related outcomes after adjusting for potential confounders. Most pertinent to our discussion was their finding of increased risk for preterm delivery among women who underwent cholecystectomy in the third trimester compared with those in the postpartum period. They concluded that patients in the third trimester should delay cholecystectomy until the postpartum period.

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