Ch 95 - Gallbladder Flashcards
Wennogle JAVMA 2019
Eubacterial fluorescence in situ hybridisation and histologic features in 25 dogs with gallbladder mucocele
Dean JSAP 2020
Diaphragmotomy to aid exposure
during hepatobiliary surgery:
a multi-centre retrospective review
of 31 dogs
Complications related to diaphragmotomy - Seven of these complications were considered attributable or likely attributable to diaphragmotomy and included one major complication (septic pleural effusion following clean surgery, n=1) and six minor complications [transient oxygen-responsive hypoxia (n=5) and haemorrhagic fluid production from the thorax (n=1)], none of which resulted in patient mortality.
Hattersley JAVMA 2020
Impact of intra-operative hypotension
on mortality rates and post-operative
complications in dogs undergoing
cholecystectomy
Hypotension - mean invasive arterial blood pressure (MAP) of <60 mmHg or a Doppler pressure of
<90 mmHg)
Friesen JSAP 2020
Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles
Viljoen JSAP 2021
Clinical characteristics and histology
of cholecystectomised dogs with
nongravity-dependent biliary sludge:
16 cases (2014-2019)
Piegols Vet Surg 2021
Association between biliary tree manipulation and outcome in dogs undergoing cholecystectomy for gallbladder
mucocele: A multi-institutional retrospective study
Results: Catheterized dogs had higher American Society of Anesthesiologists scores (P = .04), higher total bilirubin (P = .01), and were more likely to have dilated CBD at the time of surgery (P < .01). Incidence of major and minor intraoperative complications was similar between the two groups. Surgical time was longer for the catheterized group (P = .01). The overall incidence of postoperative complications was similar between the groups; however, postoperative pancreatitis was associated with performing CBD catheterization (P = .01). This association was retained as an independent association in a multivariable model that addressed baseline group differences (P = .04). Likelihood of developing postoperative pancreatitis was not different between normograde and retrograde catheterization (P = .57).
Conclusion: Catheterization of the CBD was associated with development of postoperative pancreatitis. This was not influenced by the method of catheterization. Clinical significance: The requirement for catheterization of the CBD during open cholecystectomy in dogs should be carefully considered, particularly in dogs without evidence of biliary obstruction because the procedure may induce postoperative pancreatitis.
Putterman Vet Surg 2021
Influence of normograde versus retrograde catheterization
of bile ducts in dogs treated for gallbladder mucocele
Results: Dogs catheterized RG were more likely to experience any postoperative complication (p = .0004) including persistence of gastrointestinal signs (p = .0003). Survival to discharge and long-term survival did not differ by group (p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization (p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG (p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication (p = .003 and p = .05). Conclusion: Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications. Clinical significance: Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality, results of this study provide some evidence to recommend NG over RG catheterization.
Simpson Vet Surg 2022
Cholecystectomy in 23 cats (2005-2021)
DeJesus JFMS 2021
Ultrasonographic evaluation of
cholecystoduodenostomy sites
in six cats
Case series summary This case series describes the postoperative ultrasonographic findings in six cats that underwent a cholecystoduodenostomy as treatment for extrahepatic biliary obstruction. The surgery site was identified in all six cats, most often within the right cranial abdomen as a thick-walled gall bladder, with a broadbased connection to the descending duodenum. Postoperatively, the biliary tree often remained distended, similar to its preoperative appearance. Recurrent extrahepatic biliary obstruction was suspected in three cats with worsening hyperbilirubinemia. Common bile duct distension was progressive in one of these cats and unchanged in another, but improved in the third. Intrahepatic bile duct distension resolved in one cat following surgery but reappeared with suspected recurrent biliary obstruction. In two cats, progressive echogenic biliary contents were associated with locally aggressive cholangiocarcinoma.
Our findings suggest that in cats with cholecystoduodenostomy and progressive increases in hyperbilirubinemia following surgery, progressive or recurrent biliary distension and/or progressive echogenic biliary contents should prompt further investigation.
Relevance and novel information Biliary diversion surgery in cats is associated with high morbidity and mortality. The ultrasonographic appearance of a postoperative cholecystoduodenostomy site has not been described, making differentiation of the expected appearance from postoperative abnormalities difficult. The goal of this study was to determine the expected ultrasonographic appearance, in order to assist in managing cats with recurrent, persistent or worsening clinical signs and biochemical abnormalities following surgery.
Barker JSAP 2020
Serological markers of gluten sensitivity
in Border terriers with gall bladder
mucocoeles
Reduced cholecystokinin and increased transglutaminase-2-IgA autoantibodies was detected in Border terriers with gall bladder mucocoeles; which is in part homologous to gall bladder disease identified in human coeliac disease. The results suggest an immunological disease with impaired cholecystokinin release may be affecting gall bladder motility and possibly contributing to mucocoele formation in Border terriers.
Kondo JSAP 2023
Laparoscopic cholecystectomy using
the subserosal layer dissection technique
in dogs: 34 cases (2015-2021)
Thirty-four dogs were included. The most common preoperative diagnosis was cholecystolithiasis
(n=29). Operative time was 190 minutes (range: 110 to 330 minutes). Subserosal layer dissection of more
than 90% of the gall bladder bed was achieved in 27 (79%) dogs. Conversion to open surgery was required
in three (8.8%) dogs. There were no cases of intraoperative bleeding, bile duct injury, or reoperation.
Clinical Significance: This study showed that laparoscopic cholecystectomy using the standardised subserosal
layer dissection technique could be performed successfully in dogs. Future prospective clinical studies
are needed to determine safety and effectiveness of this technique compared to standard techniques
