Choledocholithiasis in pregnancy: When and how to perform ERCP?

Prevalence of cholelithiasis in pregnancy varies from 1 % to 12 % depending on the study population. Approximately 1 % of those with gallstone disease develop symptoms. The diagnosis is made by clinical signs, laboratory tests and transabdominal ultrasound (TUS) for evaluation of the gallbladder and bile ducts. Magnetic resonance cholangiopancreatography (MRCP) should be considered for indeterminate cases. It allows to identify patients with clear ducts e. g. after spontaneous stone passage who do not need therapeutic interventions. On the other hand, in case of stones, it enables the number, size and location to be determined. This provides important information for therapy. Endoscopic ultrasound (EUS) can be considered as alternative for diagnosis. Its invasiveness is relative if the procedure is performed in the same session as ERCP that should be limited to proving existence of ductal stones [ 1 ]. Publication History Publication Date: 07 October 2020 (online) © 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Refers to: Real-time transabdominal ultrasound-guided ERCP is feasible and effective in pregnancy: a case series Endosc Int Open 2020; 08(10): E1504-E1507 DOI: 10.1055/a-1191-2680