Cholelithiasis and choledocholithiasis in a cat

Ultrasonographic Features of Extrahepatic Biliary Obstruction in 30 Cats

“…We found a shorter duration of clinical signs in the cholelith group than in the inflammation or tumor groups. This is consistent with previous reports on extraheptaic biliary obstruction caused by cholelithiasis and tumors or inflammatory diseases 6,7,33–36 . Based on this observation, we speculated that a cholelith is more prone than inflammation and neoplasia to induce an acute/subacute complete obstruction of the biliary tree as it occludes the biliary lumen.…”

Choledochotomy and primary repair of extrahepatic biliary duct rupture in seven dogs and two cats

“…Obstructive choledocholithiasis was the inciting reason for the clinical signs and surgical treatment in six of nine cases, four dogs and two cats. In the veterinary literature, cholelithiasis is the most common indication for choledochotomy, and several case reports have documented mortality rates up to 100% with this procedure (Binns 1964, Naus and Jones 1978, Cosenza 1984, Martin and others 1986, Jorgensen and others 1987, Bjorling 1991, Kirpensteijn and others 1993, Breznock 1998, Mayhew and others 2002, Harvey and others 2007). Choledochotomy is generally avoided for management of choledocholithiasis if choleliths can be flushed normograde or retrograde, due to a perceived poor outcome with postoperative leakage, dehiscence and stricture (Matthiesen 1989, Martin and others 2003).…”

“…A variety of suture types, sizes and patterns have been described for closure of choledochotomy and primary repair of extrahepatic biliary duct rupture. In the past, the use of chromic surgical gut or non‐absorbable suture, such as silk or polypropylene, had been recommended (Binns 1964, Bieritz and Brasmer 1966, Bellenger 1973, Berzon 1981, Thompson 1981, Cosenza 1984), as well as multiple layer closure with Connell or Lembert suture patterns (Binns 1964, Naus and Jones 1978). However, most surgeons currently advocate utilisation of small (4‐0 to 6‐0) monofilament absorbable suture in a simple interrupted or simple continuous pattern, depending on the size of the bile duct (Bjorling 1991, Martin and others 2003, Fossum 2007).…”

“…Each is indicated in different situations depending on the clinicopathological findings in each individual case. Choledochotomy and primary repair of extrahepatic biliary duct rupture have been described in several case reports, but, to the authors’ knowledge, long‐term outcome has not been extensively investigated (Binns 1964, Naus and Jones 1978, Cosenza 1984, Martin and others 1986, Jorgensen and others 1987, Bjorling 1991, Kirpensteijn and others 1993, Mayhew and others 2002, Amsellem and others 2006, Moores and Gregory 2007, Harvey and others 2007). Potential indications for choledochotomy include choledocholithiasis, obstructive biliary sludge and inspissated bile, and bile duct neoplasia (Matthiesen 1989, Fahie and Martin 1995, Breznock 1998).…”

Liver and biliary tract

“…Cholecystotomy or choledochotomy alone can be performed to remove stones but most authors believe that leaving the gallbladder in situ may predispose to recurrence and leaves a nidus of disease. 7,87,88 Sample procurement for aerobic and anaerobic culture is always indicated.…”