Gallstones in pregnancy and their complications: Postpartum acute pancreatitis and acute peritonitis

Pregnancy is associated with a heightened risk of gallstone formation because of increased bile lithogenicity as a result of a decline in the bile salt pool and elevations in serum and biliary cholesterol levels. Increased bile stasis caused by impaired gallbladder emptying is also thought to be a contributing factor. In the case of mildly symptomatic gallstones, conservative management is recommended. It is now agreed that aggressive endoscopic intervention for biliary disorders in pregnancy and in the postpartum period appears to decrease morbidity, mortality, and costs. Endoscopy offers a safer, more effective treatment alternative to prolonged medical management and traditional surgical intervention during pregnancy and in the postpartum period.