Ursodeoxycholic Acid for the Prevention of Relapse of Pregnancy-Related Acute Gallstones Pancreatitis

INTRODUCTION: Acute gallstones pancreatitis has an increased incidence after pregnancy. Gallstones may spontaneously disappear after delivery; cholecystectomy during pregnancy is challenging whereas ursodeoxycholic acid is safe during the last 6 months of pregnancy and effective in dissolving small gallstones. Based on these considerations, prevention of recurrent acute pancreatitis during and after pregnancy is unclear. METHODS: Between 2002 and 2015, we treated women with acute pancreatitis related to small gallstones (< 1 cm in diameter) during pregnancy or within the first post-partum year, who refused surgery, using ursodeoxycholic acid until stones dissolution. Patients were followed for 79.5 + 9.35 months (mean + SD) with seiate clinical and ultrasonographic control. RESULTS: ursodeoxycholic acid was effective in dissolving small stones in 13/14 women in 7.77 + 3.14 months (mean + SD). Only 2 patients experienced recurrent acute pancreatitis (at 1 and 88 months after the first episode). DISCUSSION: ursodeoxycholic acid may be used during pregnancy to postpone surgery. After delivery, medical treatment should be reserved only for women, refusing cholecystectomy with seriate ultrasonographic control to exclude gallstones recurrence.