胆道系急性膵炎妊婦における胆嚢摘出術は妊娠後期に安全:ERCPは妊娠全期間で安全
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role: expert
domain: 医療
policy: 各セクション名の直後に内容のみを出力し、空欄は禁止。余分な説明や補足は一切禁止。
outputs:
  – name: タイトル
    desc: 記事のタイトルを日本語に翻訳
  – name: 要旨
    desc: 記事の主要なポイントを日本語で要約
  – name: 方法
    desc: 研究の方法論を日本語で記述
  – name: 結果
    desc: 研究の結果を日本語で記述
  – name: 臨床的意義
    desc: 研究結果の臨床的な意味合いを日本語で記述
  – name: 情報源
    desc: 研究の出典を日本語で記述
  – name: 限界
    desc: 研究の限界点を日本語で記述
  – name: 開示
    desc: 研究の資金提供や利益相反に関する情報を日本語で記述
input:
  article: |
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.0ReferencesReferencesTarján D, Szalai EÁ, Erőss B, et al. Safety and effectiveness of cholecystectomy and endoscopic retrograde cholangiopancreatography in biliary pancreatitis during pregnancy: BORN Study. United European Gastroenterol J. Published online October 04, 2025. doi:10.1002/ueg2.70121CreditsLead image: E+/Getty ImagesMedscape News UK © 2025 WebMD, LLCSend comments and news tips to uknewsdesk@medscape.co.uk.Cite this: Cholecystectomy Safe During Late Pregnancy in Biliary AP – Medscape – October 14, 2025.
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出力テンプレート:
【タイトル】

【要旨】

【方法】

【結果

胆道系急性膵炎妊婦における胆嚢摘出術は妊娠後期に安全:ERCPは妊娠全期間で安全 — role: expert domain: 医療 policy: 各セクション名の直後に内容のみを出力し、空欄は禁止。余分な説明や補足は一切禁止。 outputs: – name: タイトル desc: 記事のタイトルを日本語に翻訳 – name: 要旨 desc: 記事の主要なポイントを日本語で要約 – name: 方法 desc: 研究の方法論を日本語で記述 – name: 結果 desc: 研究の結果を日本語で記述 – name: 臨床的意義 desc: 研究結果の臨床的な意味合いを日本語で記述 – name: 情報源 desc: 研究の出典を日本語で記述 – name: 限界 desc: 研究の限界点を日本語で記述 – name: 開示 desc: 研究の資金提供や利益相反に関する情報を日本語で記述 input: article: | 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.0ReferencesReferencesTarján D, Szalai EÁ, Erőss B, et al. Safety and effectiveness of cholecystectomy and endoscopic retrograde cholangiopancreatography in biliary pancreatitis during pregnancy: BORN Study. United European Gastroenterol J. Published online October 04, 2025. doi:10.1002/ueg2.70121CreditsLead image: E+/Getty ImagesMedscape News UK © 2025 WebMD, LLCSend comments and news tips to uknewsdesk@medscape.co.uk.Cite this: Cholecystectomy Safe During Late Pregnancy in Biliary AP – Medscape – October 14, 2025. — 出力テンプレート: 【タイトル】 【要旨】 【方法】 【結果

妊娠中の胆石性急性膵炎における胆嚢摘出術とERCPの安全性・有効性

研究の背景と目的

妊娠中の胆石性急性膵炎(AP)に対する胆嚢摘出術の最適なタイミングは不明確であり、臨床医はしばしば手術をためらう傾向がある。本研究は、妊娠中の胆石性AP女性における胆嚢摘出術と内視鏡的逆行性胆管膵管造影(ERCP)の安全性と有効性を評価するための国際後方視的多施設コホート研究である。

研究方法

2011年1月以降に治療を受けた胆石性APの妊婦101名が研究対象となった。このうち86%が軽度APであり、9%が中等度、5%が重度APであった。

主な結果

胆嚢摘出術の有効性: 胆嚢摘出術を受けたグループでは、1年以内に胆道系合併症による再入院が皆無であったのに対し、胆嚢摘出術を受けなかったグループでは24%が再入院した。再入院の主な原因は、AP再発、胆嚢炎、胆管炎であった。

安全性:

早産率は、胆嚢摘出術グループと非胆嚢摘出術グループ間で有意な差は認められなかった

胎児損失率は、胆嚢摘出術グループで非胆嚢摘出術グループよりもわずかに高かった(18% vs 2%; P = .050)。しかし、これらの胎児損失は全て妊娠初期に処置が行われた場合に発生していた。

ERCPの実施は、再入院、胎児損失、早産率に影響を与えなかった

妊娠中のERCPと胆嚢摘出術の間で、再入院、早産、胎児死亡率は同程度であった。

臨床的示唆

軽度の胆石性APの妊婦に対して、胆嚢摘出術は妊娠中期および後期に安全に実施可能であり、ERCPは全ての妊娠期間を通して安全に実施可能である。

研究の限界

本研究は後方視的であるため、併存疾患、社会経済的状況、栄養、麻酔法、産科管理戦略などの交絡因子が十分に捕捉されていない可能性がある。また、国際多施設研究であるため、手術時期、ERCPプロトコル、産科支持療法にばらつきがあり、結果に影響を与えた可能性がある。長期的な発達上の転帰は評価されていない。

元記事:Cholecystectomy Safe During Late Pregnancy in Biliary AP