shunt panc & tube Flashcards
McAlexander, JAVMA 2024
Diagnostic and surgical treatment for traumatic bile peritonitis in dogs and cats
-what was the mortality rate?
12%
Solari, JSAP 2024
Outcome of dogs diagnosed with concurrent intrahepatic portosystemic shunts and vertebral lesions: six cases (2016-2022)
-what was the median duration of antibiotics?
-112 days
[all dogs also underwent endovascular attenuation and all physitis/ discospondylitis resolved]
Cleary, JAVMA 2023
Features, management, and long-term outcome in dogs with pancreatitis and bile duct obstruction treated medically and surgically: 41 dogs (2015–2021)
-what was the survival rate of a) surgical and b) medically managed EHBO with pancreatitis?
surgical : 95%
medical: 57%
Spies. vet surg 2024
Clinical presentation and short-term outcomes of dogs ≥15 kg with extrahepatic portosystemic shunts
-what was the most common breed presented?
-most common shunt configuration?
-short term complication rate of sx?
-mortality rate of surgically treated?
-golden retriever
-portocaval, followed by splenocaval
-35% short term complications
-6.7% mortality
Poggi, vet surg 2024
Laparoscopic resection of pancreatic masses in 12 dogs
-which device was used most commonly to complete the partial pancreatectomy?
-complication rate?
-what case selection criteria were recommended for the technique?
- ligasure in 9/12
-33% complications - small(<60 mm in diameter) neoplasms in the right or left pan-creatic lobe that have not invaded vital structures ormetastasized. Enucleation of neoplasms in the body ofthe pancreas may also be possible in selected dogs
Larose, vet surg 2024
Near-infrared fluorescence cholangiography in dogs: A pilot study
- How early prior to surgery can low dose ICG be given to result in optimal images?
0.05 mg/kg of ICG administered at anesthetic premedication, or as early as 3 h prior to laparoscopic surgery should yield optimal fluorescence images.
Janas, Vet surg 2024
Clinical outcomes for 20 cats with congenital extrahepatic portosystemic shunts treated with ameroid constrictor ring attenuation (2002–2020)
-what percentage of cases had complications?
[what percentage had neuro signs]
-how many cats had longterm good- excellent clinical outcome?
-25% complications [ 4/5 were neuro signs]
-16/18 (89%)
Chen, vet surg 2024
Accuracy, precision, and interobserver and intraobserver agreements related to pressure-measurement devices
-which was the most accurate device for pressure measurement?
water manometer with built in gauge.
[any were suitable all within 1.3cm H2O]
Brad Case, Vet surg 2024
Laparoscopic partial pancreatectomy of the left limb using a harmonic scalpel in nine cats
-what post-op complication was encountered?
-which post-op blood parameter changed?
-sterile peritonitis (1/9)
-TLI decreased (PLI and hemoglobin A1C unchanged)
[hemoglobin A1C measures average glucose levels in blood]
Bergen, vet surg 2024
Clinical use of uncovered balloon-expandable metallic biliary stents for treatment of extrahepatic biliary tract obstructions in cats and dogs: 11 cases (2012–2022)
-what was the 2 week mortality rate?
-long term complications encountered?
-18% died within 2 weeks
-1 recurrent choleliths, 1 cholangiohepatitis and so stent was removed.
all stents placed through open abdomen approach
Azuma, vet surg 2024
Three-dimensional versus two-dimensional laparoscopy for cholecystectomy in a canine cadaveric study
-what was the impact of technique on speed?
- no difference in overall speed of surgery. faster time from insertion of instruments to first endoclip in 3d technique.
Anglin, JAVMA 2021
Clinical characteristics of, prognostic factors for, and long-term outcome of dogs with multiple acquired portosystemic shunts: 72 cases (2000–2018)
-what factors reduced the likelihood of death?
-those not on medical management at presentation, and those with normal mentation at presentation
Solari, JAVMA 2022
Percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts in small and toy-breed dogs: 20 cases (2015–2021)
-intra-op complications?
-Post-op complication rate?
-Clinical signs resolved in… %?
-20% intra-op (anaesthesia related)
-5% post op complications
-95% clinical signs resolved.
Carrera, JAVMA 2022
Long-term outcome and quality of life of dogs that developed neurologic signs after surgical treatment of a congenital portosystemic shunt: 50 cases (2005–2020)
this paper included only dogs that survived at least 30 days
- what proportion of dogs that had post attenuation seizures had recurrent seizures?
-what percentage of owners graded long term outcome as high?
-what % dogs survived >6 months?
-50% HALF had recurrent seizures
-82%
-90% survived 6 months
So summary - if have pans and survive 30 days, long term prognosis pretty good.
Economu, JFMS 2022
Surgical treatment and outcome of intrahepatic shunts in 12 cats
-rate of post-attentuation neurological syndrome?
-mortality rate?
50% PANS
17% mortality (PTS due to PANS)
White JSAP 2020
Classification of portosystemic shunts entering the caudal vena cava at the omental foramen in dogs
What subtype fits the description of the shunts below:
a) Left gastric vein (LGC) to CVC with no flow through the right gastric vein
b) Left gastric vein to CVC with flow through RGV, splenic vein has 2 communications with LGV
ANSWER A: LGV subtype RGV (-): LGV to CVC shunt, no shunt flow through RGV.
NEGATIVE NO FLOW
LGV subtype RGV (i): Same shunt, with shunting flow through RGV & no communication between LGV & splenic vein.
ANSWER B: LGV subtype RGV (ii): Same shunt + RGV flow, splenic vein has 2 communications with LGV.
TYPE TWO - TWO COMMUNICATIONS LGV
LGV subtype RGV (iii): Same shunt + RGV flow, splenic vein communicates with LGV but not directly with portal vein.
Matiasovic, vet surg 2019
Outcomes of dogs treated for extrahepatic congenital portosystemic shunts with thin film banding or ameroid ring constrictor
-what % had revision surgery persistent shunting in thin film band group?
-what % in ameroid group?
29% thin film band, 0% ameroid.
significant difference.
Joffe, vet surg 2019
Evaluation of different methods of securing cellophane bands for portosystemic shunt attenuation
-which clip was least likely to fail?
-How many layers of cellophane band were less likely to fail?
- A single medium clip withstood physiological forces and secured a cellophane band at up to 50% attenuation.
-A 3-layer cellophane band was more likely to fail compared with a 4-layer cellophane band.
conclusion: use 4 layer band, medium clips.
Mullins, vet surg 2020
Prognostic factors for short-term survival of dogs that experience post-attenuation seizures after surgical correction of single congenital extrahepatic portosystemic shunts: 93 cases (2005-2018)
- what was % survival to 30 days?
-what factors were linked to short-term survival
-32% survived to 30 days
- history of pre-op seizures, focal PANS only.
Carroll, vet surg 2021
Feasibility of thoracoscopic attenuation of the azygos vein as a model for portoazygos shunts: A canine cadaveric study
where were ports placed?
Three thoracoscopic ports right hemithorax
-at the mid-10th intercostal
-dorsal third of 9th intercostal
-dorsal third of 11th intercostal
Strickland, vet surg 2021
Incidence and risk factors for neurological signs after attenuation of a single congenital portosystemic shunt in 50 cats
-frequency of PANS post op?
-what was mortality rate?
-what was a risk factor for PANS?
-PANS in 62%
-10% mortality rate (5 didnt survive)
-Osmolality at a median 24 hours postoperatively was lower in cats with PANS
Sunlight, vet surg 2022
Protein C and comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts
- what % did post op protein C increase in?
-mean increase?
-what factor was higher in dogs with better clinical status?
-79% had increase post op protein C
-39% mean increase
Postoperative, but not preoperative, PC activity was higher in dogs with better ultimate clinical status.
Complete occlusion of shunts was associated with a higher postoperative PC and superior ultimate clinical status.
Devriendt, vet surg 2022
Evaluation of different blood tests in dogs with extrahepatic portosystemic shunts to assess shunt closure after surgical treatment
-which individual blood test had the highest specificity for shunt closure?
-which individual blood test had the highest sensitivity?
-fasting ammonia individual test with highest specificity
- serum hyaluronic acid AND lidocaine/monoethylglycylxylidide (L/MEGX) test (15 minutes after lidocaine) were individual tests with highest sensitivity
Collgros, JAVMA 2023
Blood glucose monitoring during surgery in dogs to assess completeness of surgical resection of insulinoma: 11 cases
-what percentage of cases had increase in glucose
-disease free interval?
-MST?
-was tumour stage associated with outcome?
-100%
-382 days
-762 days
-tumor stage not associated with outcome
3 cases underwent second surgery metastatectomy
Ryan, JSAP 2021
Clinical findings, neurological manifestations and survival of dogs with insulinoma: 116 cases (2009-2020)
-what was most common presenting sign
-what were survival times? was there a difference between medical and surgical?
-what other variable associated with prognosis?
weakness
Overall survival longer for surgery (20 months) vs medical management (8 months).
Presence of mets was only other variable associated with prognosis.
Coss, JSAP 2021
The appearance of canine insulinoma on dual phase computed tomographic angiography
-what was the CT appearance of insulinoma
In contrast to recent publications, this study suggests hyperattenuation of insulinomas in the arterial phase is a predominant feature, and that hypoattenuation or isoattenuation are much less common
Wolfe, JSAP 2022
Perioperative outcomes in dogs and cats undergoing pancreatic surgery: 81 cases (2008-2019)
-what was the most common diagnosis in dogs and cats?
-mortality rate?
-Most common diagnosis islet cell carcinoma (dogs) & pancreatitis (cats).
- Overall mortality rate 13.6% - 10% dogs, 20% cats.”
Veytsman, vet surg 2023
Retrospective study of 20 cats surgically treated for insulinoma
-what was overall survival time?
-what % cats did tumour excision lead to immediate euglycemia?
-what prognostic factor linked to DFI?
-what prognostic factor linked to overall survival time?
-Median OST for all cats was 863 days
-90%
-age at presentation and mets at surgery linked to DFI
-histopathologic tumor invasion linked to OST.
Perondi, JSAP 2021
Oesophagostomy tube complications in azotaemic dogs: 139 cases (2015 to 2019)
-what were risk factors for compliations?
-what was complication rate?
-indwelling time, use of haemodialysis
-50% complication rate
Camacho, JSAP 2024
Complication rates associated with nasoesophageal versus nasogastric feeding tube placement in dogs and cats: a randomised controlled trial
-overall rate of complications during placement?
-what % had tube placed in resp tract?
-what technique used to confirm placement in resp tract?
-26%, no significant difference betweeen NG and NO tube
-3% tube in resp tract
-capnography
