Introduction : During the second trimester of twin pregnancy, laparoscopic cholecystectomy is considered impractical because of large uterine size. We present a second trimester twin pregnant patient who underwent a laparoscopic cholecystectomy for biliary colic.

Methods : A 31-year-old female, 24 weeks twin pregnant, was admitted to the obstetrics clinic with the first episode of epigastric pain, radiating to the back, associated with nausea from a week ago before she was admitted. The ultrasonography revealed multiple gallstones without evidence of acute cholecystitis. The patient was placed on the left lateral decubitus position. Considering the fundal height, subcostal 12mm trocar was inserted as a first port using open method. And the other trocars were placed at the Mcburney point and at the epigastrium using 5mm trocars.

Results : Total operation time was 35 minutes. The operation was finished without an accident. In the recovery room, she had premature contraction and the fetal heart monitoring sometimes revealed bradycardic episodes, and she was placed on continuous magnesium infusion. On 14th post-operative day, she had high fever(38℃) with chilling sign and complained of epigastric pain. Endoscopic retrograde chaolangiopancreatography was done with minimal sedation and fluoroscopy. The common hepatic duct dilatation and a small orifice of amuplla were observed, and endoscopic sphincterotomy was performed. (Moreover,) On the MRI, there was no fluid collection around the operative site. She was then well-recovered in the ante-partum unit and was discharged on 30th post-operative day.

Conclusions : Laparoscopic cholecystectomy and postoperative management during second trimester of twin pregnancy is safe and feasible.