The Efficacy and Safety of Performing Percutaneous Transhepatic Cholangioscopy (PTCS) Under Local Anesthesia for Pregnant Patient Suffering Acute Cholecystitis: A Study Protocol of a Prospective, Single-center, Single-arm Pilot Study

Background Acute cholecystitis (AC) during pregnancy presents a clinical dilemma, as standard treatments like laparoscopic cholecystectomy (LC) involve general anesthesia, which carries risks for both the mother and fetus. Percutaneous Transhepatic Cholangioscopy (PTCS) under local anesthesia has emerged as a promising alternative, offering a safer approach for pregnant patients with AC. This study evaluates the safety and efficacy of PTCS under local anesthesia in pregnant women with acute cholecystitis. Methods This prospective, single-center, open-label pilot study enrolled pregnant women aged 18–40 years, diagnosed with acute cholecystitis, who met the inclusion criteria. PTCS was performed under local anesthesia using 2% lidocaine and 15 mg dexamethasone for intercostal nerve blockade. The primary outcome was the resolution of acute cholecystitis, defined as successful gallstone removal and symptom relief. Secondary outcomes included maternal and fetal safety, recovery time, and the need for further interventions. Data were compared with historical control groups receiving conservative treatment or laparoscopic cholecystectomy. Discussion PTCS under local anesthesia demonstrated promising results in resolving acute cholecystitis, with minimal maternal and fetal complications. The procedure was well-tolerated, with reduced anesthesia-related risks and shorter recovery times compared to general anesthesia. Fetal safety was maintained, and no significant adverse outcomes were observed. This approach could offer an effective, minimally invasive alternative for managing acute cholecystitis in pregnant patients, reducing the need for more invasive surgical interventions. Larger, randomized studies are needed to confirm these findings and assess long-term outcomes. Trial registration