Ch. 95: Liver & Biliary Flashcards
Rogers JVECC 2020
Prevalence and impact of cholecystitis on outcome in dogs with gallbladder mucocele
% with cholecystitis?
Association between cholecystitis and survival? Cholecystitis and intra-op culture?
% in hospital mortality?
29% had cholecystitis
No association between cholecystitis or subtypes & survival
No association between cholecystitis and intraop bacterial culture positivity
17% dogs (38) died or euthanized during hospitalization
Piegols VSURG 2020
Association between biliary tree manipulation and outcome in dogs undergoing cholecystectomy for gallbladder mucocele: a multi-institutional retrospective study
3 significant findings associated with catheterized dogs?
Difference in incidence of intra-op comps between groups? Post-op complications?
What post-op complication was associated with CBD catheterization? Did normograde vs retro matter?
Catheterized dogs: higher ASA scores, higher total bilirubin, and were more likely to have dilated CBD at the time of surgery
No difference for either; incidence of intra- and post-op complications similar between groups
Post-op pancreatitis associated with performing CBD catheterization (OR 8) - but not different bw norm or retrograde cath
Putterman VSURG 2021
Influence of normograde versus retrograde catheterization of bile ducts in dogs treated for gallbladder mucocele
Post-op complications more common with what group?
% survival to discharge? What was difference between groups?
% decrease in TBili after NG flush? RG flush?
% increase in in TBili after NG flush? RG flush?
Significance of diplomate surgeon presence?
Dogs catheterized RG were more likely to experience post-op complications, esp. persistence of GI signs
86% survived to d/c - no difference between groups with survival to discharge or long-term survival
TBILI:
Decreased in - 70% NG, 39% RG
Increased in - 15% NG, 38% RG
Incidence of any periop or postop complications were decreased when a diplomate was present (good thing we will be boarded soon :) )
Pavlick JVIM 2021
Evaluation of coagulation parameters in dogs with gallbladder mucoceles
% dogs with hypercoagulability based on TEG parameters?
Did this match plasma-based coag testing results?
83% dogs had results consistent with hypercoagulability based on TEG parameters, maximal amplitude, and G
No - plasma-based coagulation testing suggested that a complex state of hemostasis exists
Griffin JVIM 2021
Choledochal stenting for treatment of extrahepatic biliary obstruction in cats
MC presenting clinical sign?
CS improved post-op in what %?
Post-op TBILI decreased in what %?
% survival to dc?
% recurrence of EHBO?
MC CS - vomiting, 91%
Post-op CS improved in 75%
TBILI decreased post-op in 68% cats
78% cats survived
Recurrence in 39%
Allan JVIM 2021
Clinical features and outcomes in 38 dogs with cholelithiasis receiving conservative or surgical management
% of symptomatic dogs with choledocholithiasis?
% incidental dogs with choledocholithiasis?
Cholethiasis resolution % in med tx? sx tx? non tx groups?
44% of symptomatic cases vs 0% of incidental had choledocholithiasis
cholelithiasis completely resolved:
50% (4/8) medically treated (Ursodiol)
71% (5/7) of surgically treated
50% (1/2) non-treated dogs
(resolution in 50% (5/10) in non-sx treatment group - but these dogs had way less # of choledocholiths) .. dumb paper
Brand VRU 2020
Computed tomographic features of confirmed gallbladder pathology in 34 dogs
MC abnormal CT findings? Pathognomonic for any pathology?
most common abnormalities detected: intraluminal nodules, gallbladder wall thickening, hyperattenuating material (35-100 HU), and mineral attenuating material (>100 HU)
Not pathognomonic for any pathologies detected
Simpson VSURG 2021
Cholecystectomy in 23 cats (2005-2021)
MC presenting CS?
MC indication for cholecystectomy?
% cats that required post-op blood transfusion?
% survival to dc?
MC short and long term post-op comp?
MC CS: Vomiting, jaundice, abdominal pain
Cholelithiasis - major indication for cholecystectomy
39% (9/23 cats) required a postop blood transfusion
(Intra-op hypotension & post-op anemia were common)
78.3% (18/23) survived to discharge
MC short-term and long-term postop complication: vomiting
Center JAVMA 2022
Clinical features, concurrent disorders and survival time in cats with suppurative cholangitis-cholangiohepatitis syndrome
Diagnostic imaging correctly found choleliths in what %?
% of cases with “idiopathic pancreatitis” actually found to have transiting choleliths?
2 survival advantages?
3 survival disadvantages?
Diagnostic imaging identified only 58% of surgically confirmed choleliths
51% (28/55) cats with “idiopathic pancreatitis” were documented to have transiting choleliths
Survival advantages: Cholelithiasis (with or without bile duct obstruction) and cholecystectomy
Survival disadvantages: leukocytosis, ≥ 2-fold increased ALP, hyperbilirubinemia
Hattersley JSAP 2020
Impact of intra-operative hypotension on mortality rates and post-operative complications in dogs undergoing cholecystectomy
which 4 factors associated with mortality (in hospital & 28 day) on univariable?
which 2 still significant on multivariable?
ASA grade, postop hypoproteinemia, ileus, and pancreatitis were associated w/ both in hospital and 28 day mortality on univariate analysis
Ileus and pancreatitis were the only factors that remained significant for mortality on multivariate analysis
Barker JSAP 2020
Serological markers of gluten sensitivity in Border terriers with gall bladder mucoceles
what 2 markers detected in Border Terriers with GBM? (decreased or increased for either?)
reduced cholecystokinin
increased transglutaminase-2-IgA autoantibodies
Viljoen JSAP 2021
Clinical characteristics and histology of cholecystectomised dogs with non gravity-dependent biliary sludge: 16 cases (2014-2019)
Majority of dogs had what GB diagnosis?
How many dogs had enteritis? Majority what kind?
12/16 (75%) dogs had cholecystitis
(11 lymphoplasmacytic, 1 neutrophilic)
13 dogs (81%) had enteritis
(12 lymphoplasmacytic, 1 eosinophilic)
Bandara JSAP 2021
Histopathological frequency of canine hepatobiliary disease in the United Kingdom
Top 3 histological diagnoses?
Most frequent histological diagnoses (4584 cases):
Reactive hepatitis (n=770);
Chronic hepatitis (n=735); (note: Labs & Spaniels predisposed)
Reversible hepatocellular injury (n=589); (note: Schnauzer)
Wilkinson JVIM 2020
Bile duct obstruction associated with pancreatitis in 46 dogs
% survival?
% of survivors treated with medical mgmt alone?
Were BD dilation or bilirubin different between survival or non survivors?
80% survival
94% of survivors had medical mgmt. alone
No - median bile duct dilation at time of dx and peak bilirubin were not different b/w survivors and non-survivors
Lindaberry JVIM 2021
Proteinuria in dogs with gallbladder mucocele formation: a retrospective case control study
What ratio of urine dipstick protein concentration to USG was found to be significantly higher in dogs with GBM formation compared to controls?
Is GBM formation significantly associated with proteinuria?
≥ 1.5
- Median urine dipstick protein conc to USG ratio was significantly higher in GBM than controls
- Number of dogs w/ ratio ≥ 1.5 was significantly higher in GBM than controls
Yes - Gallbladder mucocele formation is significantly associated with proteinuria in dogs
Jaffey JVIM 2022
Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele
2 independent predictors of death after cholecystectomy?
What variable & with what ORs, affected odds of death with GB rupture vs not ruptured?
Independent predictors of death after cholecystectomy:
- age (OR 2.81)
- intraoperative systolic blood pressure (SBP) nadir.
- odds of death associated with intraop SBP nadir were different for dogs with and without GB rupture
- SBP nadir in dogs with GB rupture (OR 0.92)
- SBP nadir in dogs without GB rupture (OR 0.88)
= Intraop SBP nadir was lower for dogs with gallbladder rupture that died compared to dogs with gallbladder rupture that survived
(but it was NOT different for dogs without gallbladder rupture that died compared to those that survived)
Wilson VRU 2021
Dogs with biliary rupture based on ultrasound findings may have normal total serum bilirubin values
% of dogs with biliary rupture that had serum bilirubin WNL?
What was the difference in serum bili between rupture vs not?
What 2 CBC findings were significantly more common in dogs w/ biliary rupture?
40% of dogs w/ confirmed biliary rupture had serum bilirubin w/in ref intervals
No difference = no sig difference in serum bilirubin values of dogs w/ ruptured vs non-ruptured biliary tracts
leukocytosis and neutrophilia were sig more common in dogs w/ rupture
Tamura VRU 2021
Extrahepatic biliary obstruction can interfere with hepatic fibrosis prediction using two-dimensional shear wave elastography in dogs
Pre-op shear wave velocity (SWVs) sig higher in which group (EHBO or not)?
Did surgery affect SWVs?
Histopath difference in hepatic fibrosis between EHBO vs no EHBO?
Pre-op shear wave velocity (SWVs) sig higher in dogs with EHBO compared to without
SWVs decreased significantly after surgery
No difference in histopathological hepatic fibrosis stages between dogs with and without EHBO
** Hernon VSURG 2023 **
The effect of flushing of the common bile duct on hepatobiliary markers and short-term outcomes in dogs undergoing cholecystectomy for the management of gall bladder mucocele: Randomized controlled prospective study **
What breed over represented?
What chemistry values (5) reduced from pre-op to 3 days post-op?
Differences between groups (flush vs no flush) for which?
Survival to discharge?
Border terriers overrepresented (65%, 20/31)
Marked reductions from pre-op to 3 days postop in:
Serum bilirubin
ALP
ALT
GGT
Cholesterol
No difference in any marker between groups (flush vs no flush)!
Survival to discharge: 90% (28/31 dogs)
No short-term clinical or clin-path benefits were identified when flushing the CBD in dogs undergoing cholecystectomy for GBM!
Jang VRU 2023
Increased radiographic opacity in the region of the gallbladder can be identified in dogs with large amounts of gallbladder sediment, sludge balls, and gallbladder mucocele
What % of dogs with GB sediment had increased opacity on at least one rad view?
Which view was most Sn to detect increased opacity?
What kind of sediment / sludge pathology had highest % of opacity?
22% (37/168) dogs with GB sediment had increased opacity on at least one radiographic projection
Sensitivity for detecting increased opacity was highest in the thoracic ventrodorsal view
Sludge balls (Group 4) was the highest percentage w/ increased radiographic GB opacity
Villm VRU 2022
Prevalence of gallbladder sludge and associated abnormalities in cats undergoing abdominal ultrasound
What % cats had GB sludge found?
What GB finding significantly increased the odds of detecting GB sludge? OR?
GB sludge present in 44% of cats that underwent an AUS
GB wall thickening significantly increased the odds of detecting GB sludge (OR 3.7)
MacLeod VRU 2023
Ultrasonographic Appearance of Gallbladder Neoplasia in 14 Dogs and 1 Cat
What was most commonly found final neoplasia diagnosis?
Neuroendocrine carcinoma (53%, 8/15)
Lamb JSAP 2018
Determining the anatomical origin of canine hepatic masses by CT
% of correct CT compared to sx findings for masses on left of midline = left divisional?
Right of midline = right divisional?
All masses (100%) to the left of midline were left divisional
Only 60% (18/30) masses to the right of midline were right divisional
Friesen JSAP 2021
Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gallbladder mucoceles
Mortality rate for each group (elective vs non elective)?
Complication rate for each?
What type of complication (minor or major) most common for elective?
What post-op finding in 35% of dogs that underwent duodenotomy & retrograde flushing?
mortality rate: 6% for elective vs 23% for nonelective
complication rate: 52% for elective and 50% for nonelective
- most complications in elective category were grade 1 (mild)
postop hyperthermia in 35% of dogs w/ duodenotomy and retrograde catheterization
Rogatko JVIM 2021
Drug-eluting bead chemoembolization for the treatment of nonresectable hepatic carcinoma in dogs: a prospective clinical trial
Tx resulted in stable disease or partial response in what %?
Major complication %?
Stable dz in 60%, partial response in 25% = 85%
(progressive disease in 15%)
10% major complications
Shaker VRU 2021
Machine learning model development for quantitative analysis of CT heterogeneity in canine hepatic masses may predict histologic malignancy
Memorize this statement:
The best performing model utilized the CT features voxel volume and uniformity from postcontrast mass contour
The best performing model utilized the CT features voxel volume and uniformity from postcontrast mass contour
Terai JAVMA 2022
Clinical, diagnostic, and pathologic features and surgical outcomes of combined hepatocellular-cholangiocarcinoma (cHCC-CCA) in dogs: 14 cases (2009-2021)
Most masses looked like what?
MST of cHCC-CCA with sx?
cHCC-CCA may be more similar in prognosis to HCC or CCA?
Massive hepatic mass with inclusion of cyst like lesions
MST HCC-CCA = 700 days
More similar to HCC with sx (695-1460d) vs CCA (180d)
Reist JAVMA 2023
Histopathologic findings and survival outcomes of dogs undergoing liver lobectomy as treatment for spontaneous hemoabdomen secondary to a ruptured liver mass: retrospective analysis of 200 cases (2012–2020)
MST for well-diff HCC? HSA? Benign?
Prognostic factors for survival (4)?
Increased __ improved the odds of diagnosing a WD-HCC by a factor of __?
Pre-op factors associated with shorter survival (3 BW, 1 other)?
Prognostic factors for survival:
diagnosis, increased ALT, anemia, & whether a transfusion was received.
Increased ALT improved the odds of diagnosing a WD-HCC by a factor of 10.7
Preoperative factors associated with a shorter survival:
decreased PCV, HCT, and albumin (blood loss)
& dogs that received a transfusion
Locatelli JSAP 2022
Percutaneous ultrasound-guided microwave ablation for treatment of hepatocellular carcinomas in dogs: four cases (2019-2020)
(Small cases series - note that it exists)
HCC were successfully ablated, which in some cases resulted in an improvement in clinical signs and laboratory values.
No immediate complications.
An VRU 2019
Evaluation of the radiographic liver length/11th thoracic vertebral length ratio as a method for quantifying liver size in cats
(Since we aren’t given the title) - What was the liver length compared to?
What was reference value of ratio?
Did it differ among signalment?
11th thoracic vertebral length
The reference value of the LL / T11 ratio was 4.22 +/- 0.54
LL/T11 ratio did not differ among signalment groups
Cheney JSAP 2019
US and CT accuracy in localizing surgical- or necropsy-confirmed solitary hepatic masses in dogs
US predicted correct location in what %?
CT predicted correct location in what %?
Sn highest for what division?
Location was correctly predicted
US: 74% dogs
CT: 84% dogs
Sensitivity was highest for left division masses
Rivas VSURG 2019
Ability of positive and negative contrast CT peritoneography to delineate canine liver lobe fissures
Which type of study improved delineation of hepatic interlobar fissures?
positive contrast CT peritoneography improved delineation of hepatic interlobar fissures in normal cadavers
von Stade JSAP 2021
Prevalence of portal vein thrombosis detected by computed tomography angiography in dogs
What was overall prevalence of PVT?
What “category” of dogs had highest % of PVT?
Of the dogs with PVT that had an US, what % did US detect?
13% prevalence of PVT
Pancreatitis category had highest % of PVT
Of 21 dogs with PVT that had ultrasound performed, ultrasound detected thrombosis in 19% (4/21)
Israeliantz VRU 2022
A simplified CT-volumetry method for the canine liver
Is sagittal reformatting and hepatic contouring accurate? How many images did they use?
Using sagittally reformatted images and hepatic contouring in as few as nine images can be an accurate and simple method for CT-volumetry of the canine liver
Spain JFMS 2022
Ultrasonographic prevalence and proposed morphologic classification of bilobed gallbladder in cats
Overall incidence of anomalous GB morphology?
Most common morphology? What are other types?
Overall incidence anomalous GB morph = 25%
Bilobed morphology MC - 14%
Others: Separated, Duplex, Complex
Linden VSURG 2019
Outcomes and prognostic variables associated with central division hepatic lobectomies: 61 dogs
What type of resection associated with complications?
Rate of intra-op complications? What was most common (%)?
Rate of immediate post-op complications?
Peri-op mortality rates - immediate vs 14 days?
Hilar resection associated with increased intraop and postop complications.
Intraop complications occurred in 48% (29 dogs) – 69% had hemorrhage (20/29) with 19/20 requiring transfusions.
Immediate postoperative complications in 33% (20 dogs)
Perioperative mortality rate 11%
2-week mortality rate was 15%
Sellier VSURG 2020 PQ
Use of a cavitron ultrasonic surgical aspirator for parenchyma-sparing and complex liver resections in dogs
How much blood loss (median) mL & % of BV?
Short term complication rate?
What device for parenchymal preservation PQ?
Lost median of 77mL blood = 4.3% BV
18%, 2/11 short term comp
1/11 died (9%) from complication
- cavitron ultrasonic surgical aspirator *
Moore VSURG 2023
Association between divisional location and short-term outcome of liver mass resection in 124 dogs
Masses more common in which division?
Intra-op comp rate?
Odds increased with what by how much?
Less intra op comp with what side?
Post-op comp rate?
More likely if they did what in sx?
Less likely with what 3 factors?
Moratlity rate? What association bw location and mortality?
Liver masses MC in the left division (58%)
Intraop complication rate 11%
- Odds of intraop comps 19 x higher when surgery was performed without a TA stapler
- Intraop comps were less commonly associated with left divisional masses than right
Postoperative comp: 29%
- Postop comps more likely:
if the incision extended to the thorax, which was more common during resection of right divisional masses - Postop comps were less likely when surgery was performed with a TA stapler, by a specialist surgeon, and in heavier dogs
Mortality 7% (8/124)
No association was detected between mass location and mortality !
Dean JSAP 2020
Diaphragmotomy to aid exposure during hepatobiliary surgery: a multi-centre retrospective review of 31 dogs
Periop mortality rate?
Post-op complication rate?
How many attributed to diaphragmotomy?
Periop mortality 10%
None attributable to diaphragmotomy
Post-op comps 68% (of those that survived periop)
- 25% (7/28) attributed to diaphragmotomy (but resolved with non sx intervention)
Reece JVIM 2020
Hemorrhage and complications associated with percutaneous ultrasound guided liver biopsy in dogs
% dogs with PCV decrease after biopsy?
Mean Δ in PCV?
Major hemorrhage in %?
85% dogs had a decrease in PCV after biopsy
Mean ΔPCV was -7.2%
Major hemorrhage occurred in 42% (but they considered clinically silent)
Takagi VSURG 2022
Computed angiographic variations in hepatic venous vasculature in dogs
Conclusion? (was there variation, especially where?)
The draining pattern of hepatic veins varied widely in all liver lobes, especially the left lateral liver lobe.
Sparago JSAP 2021
Investigation of the association between gall bladder wall thickness and hypoalbuminemia in dogs
Were albumin and GB wall thickness correlated in the study groups?
What correlation was found? relates to immune mediated disease
Serum/plasma albumin concentration and gallbladder wall thickness were not significantly correlated in groups 1&2
A moderate negative correlation (-0.64) between gallbladder wall thickness and albumin concentration in dogs with immune-mediated diseases
Mattolini VRU 2023
CT features of divisional bile ducts in healthy Labrador Retrievers
How many dogs could at least 1 division of bile duct be seen?
At least 1 of the divisional bile ducts could be visualized using contrast-enhanced CT in the majority of sampled dogs (75%)
Dickerson VSURG 2023
Outcome in 38 dogs surgically treated for hepatic abscessation
Pre-op peritoneal effusion in %?
Which org most common cultured?
Rate of neoplasia?
Complication rate?
Periop mortality rate?
Recurrence rate?
Overall long term px considered?
Peritoneal effusion in 84% (32/38) preop
Escherichia coli most common
Hepatic neoplasia in 31% (11/36)
of dogs that survived sx, complications in 58% (21/36)
Periop mortality 21% (8/38) =
2 dogs died intraop, 6/36 dogs died prior to discharge.
Recurrence rate 0%
Long term px is good
Ambrosini JVIM 2022
Serum 25-hydroxyvitamin D and C-reactive protein and plasma von Willebrand concentrations in 23 dogs with chronic hepatopathies
Correlations bw Vitamin D, C-reactive protein, and vWF with chronic hepatopathies?
- Vitamin D concentration was negatively correlated with disease activity
- CRP was positively correlated with histopath necroinflammatory activity and fibrosis score;
- vWF concentration was positively correlated with fibrosis score
Basic: In dogs with CH, serum 25(OH)VD concentration was negatively correlated with disease activity, whereas serum CRP concentration and plasma vWF concentration were positively correlated with histopathologic grade and stage
Butler JVIM 2022
A multicenter retrospective study assessing progression of biliary sludge in dogs using ultrasonography
Which breeds were independent risk factors for development of GB mucocele? OR?
How did biliary sludge scores affect GBM formation?
- Shetland Sheepdogs OR 41 and Border Terriers OR 12, more likely to develop GBM
- Odds for GBM formation increased with biliary sludge scores
O’Kell JVIM 2022
Gastroduodenal ulceration (GDU) in dogs with liver disease
Rates of GDU and erosions?
10% (4/40 dogs) had Gastroduodenal ulceration
15% (6/40) had erosions
Oramas VSURG 2019
Laparoscopic access to the liver and application of laparoscopic microwave ablation in 2 dogs with liver neoplasia
What lobes accessible?
MWA feasible?
Complications in 2 case dogs?
All lobes of canine liver accessible via laparoscopy ; used 17 g MWA probe
15 reverse Trendelenburg; 5 mm port caudal to umbilicus; then 2nd port 1/3 distance between umbilicus and xiphoid
Inserted probe for ablation as proximal on hilus as possible ; cycle for 30 watts for 10 sec
Histopath diagnosis tx by LMWA included met HSA and primary hepatocellular carcinoma
Laparoscopic microwave ablation feasible, and no complications occurred
Conclusion: laparoscopic access to hilus of each liver lobe possible via VD approach provided reverse Trendelenburg & lateral rotation is used, especially for right lateral lobe;
Simon VSURG 2020
Laparoscopic cholecystectomy with single port access system in 15 dogs
What did they need to do in 12 cases?
Risk of conversion decreased with what?
Complications?
SPAS placed 1 cm caudal to umbilicus; completed with SPAS alone in 2 cases
Additional cannula added in 12 cases
Last 10 cases additional cannula placed at beginning of procedure
Dissection began at the cystic duct in 11 dogs (73%); in 3 cases (20%) SPAS converted to laparotomy; 2 of these conversions were elective, and one was emergent
Risk of conversion was affected by experience of the surgeon & rate of conversion reduced when cannula added at beginning of procedure
Intraop complications in 4 cases – 3 minor with bleeding of liver parenchyma; 1 major leakage of bile from dissection
14 dogs discharged from hospital
1 dog died after being discharged due to severe cholangiohepatitis & another dog died due to leakage of gastrostomy tube
Conclusions: use of SPAS has acceptable outcome; experience and extra cannula reduced risk of conversion
Michael (hehe) VSURG 2021
Feasibility of laparoscopic liver lobectomy in dogs
LLL feasible for what lobes?
LLL not possible in what lobes?
Large cadavers what issues?
Clinical cases - what indications determined?
LLL was feasible for left and central division in small cadavers.
LLL of right division was not possible because of inability to articulate the stapler anvil across the hilus.
Stapler closure was complete and only one cartridge was used per lobe in small cadavers.
In large cadavers, resection was not successful because of incomplete closure of the stapler anvil and staples in any of the left and central division lobes and was not possible in right division lobes because of inability to articulate the stapler anvil across the hilus.
6 clinical cases – wts 8-38.5 kg, 4/6 quadrate partial LLL, 2/6 left lateral partial LLL. Resection 30, 60, 90%. Diagnoses HCC 3/6, chronic fibrosis 1/6, nodular hyperplasia 1/6, biliary cyst adenoma 1/6.
1/6 cases needed conversion, which was 38.5 kg dog with large mass in left lateral lobe.
LLL: similar indications to humans (peripherally located masses <5 cm)
Poggi VSURG 2022
Laparoscopic portosystemic shunt attenuation in 20 dogs (2018-2021)
What did they attenuate with?
Conversion %? Why?
Outcomes? occlusion? BAs?
Shunt in epiploic foramen in 14 dogs
13/14 right paramedian approach, 1/14 left
Not located in epiploic foramen 6 dogs
left paramedian
Thin film band in all dogs
Conversion required in 5 dogs (25%)
- Failure to identify shunt 2 (10%)
- Moderate hemorrhage 2 (10%)
- Perforation of the diaphragm 1
Mild, self-limiting portal hypertension occurred in 3 dogs
- Severe requiring conversion in 1 dog
Second procedure needed for a dog with portal hypertension, replaced and did well after second procedure
All dogs had good outcome
All complete occlusion, 95% had normal bile acids within 3 months of surgery
95% of dogs (one dog follow up not needed) had no medications at long-term follow up
89% complete owner satisfaction
Kanai VSURG 2022
Intraoperative cholangiography and bile duct flushing in 47 dogs receiving laparoscopic cholecystectomy for benign gallbladder disease: a retrospective analysis
Dissection method of GB?
Complications?
Conclusion?
LC used BDF method
Dissection within the subserosal layer of the gallbladder from the fundus to the cystic duct prior to transection
Procedure: Infundibulum ligated then incision made in cystic duct for IOC; catheter 4-7 Fr feeding tube inserted into cystic duct
Fed until the side hole was hidden inside lumen of cystic duct
If hard to place, used guidewire
Catheter and tissues clamped with atraumatic forceps
Flushed then contrast flushed with C-arm fluorscopy
Median procedure time for BDF and intraoperative cholangiography (IOC) was 4 min
No intraoperative or postoperative complications
4% died
During LC, BDF and IOC were performed safely and successfully. Intraoperative cholangiography identified obstructions and strictures in the common bile duct that were not detected using BDF alone.
Kondo JSAP 2023
Laparoscopic cholecystectomy using the subserosal layer dissection technique in dogs: 34 cases (2015-2021)
Success in %?
Conversion rate?
Intraop bleeding and bile duct injury?
To describe a standardized subserosal layer dissection technique and evaluate its outcomes in canine laparoscopic cholecystectomy
34 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 gallbladder 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.
