Correlation between Ultrasonographic Imaging of the Gallbladder and Gallbladder Content in Eleven Cholecystectomised Dogs and their Prognoses

Abstract

ABSTRACT. A comparison was performed between preoperative ultrasonographic and macroscopic findings for gallbladders and their contents in eleven dogs that were found to have any content in the gallbladder and then underwent cholecystectomy. In addition, correlation was considered between prognosis and age, hematologic analysis, serum biochemical analysis and ultrasonographic findings. Ultrasonographic findings of the gallbladder were classified into 3 patterns: 1) hyperechoic content filling the entire gallbladder and precipitated immobile content, 2) a somewhat thinner hypoechoic area in the exterior layer with a less distinctive border adjacent to the internal hyperechoic area than pattern 3 with moth-eaten or mosaic-form hypoechoic portions scattered within the internal hyperechoic area and 3) a thick hypoechoic area in the exterior layer with a distinctive border adjacent to a prominent internal hyperechoic area. The macroscopic findings of the contents mainly consisted of biliary sludge and concentrated bile in pattern 1, a softer mucous mass in pattern 2 and an elastic mucous mass in pattern 3. Pattern 2 seemed to be in the stage before the kiwi fruit-like pattern that characterizes gallbladder mucocele, suggesting disorder of the gallbladder and bile excretion as well as onset of cholangiohepatitis associated with such disorders. In regard to association with prognosis, the mean ages were 11.8  1.5 years in death cases and 8.4  2.8 years in surviving cases, while the total WBC counts were 46,600  11,912 /L in the death cases and 18,266  9,411 /L in the surviving cases, showing significant differences (p<0.05) in age and total white blood cell count between the two groups.

Eubacterial fluorescence in situ hybridisation and histologic features in 25 dogs with gallbladder mucocele

“…The reason for perioperative death following cholecystectomy for treatment of GBM is not well understood. Although concurrent bacterial infection has not been correlated with perioperative mortality (Besso et al 2000, Pike et al 2004, Worley et al 2004, Aguirre et al 2007, Crews et al 2009, Uno et al 2009, Malek et al 2013, the rate of bacterial infection has been variably described (Pike et al 2004, Worley et al 2004, Aguirre et al 2007, Crews et al 2009, Uno et al 2009, Malek et al 2013, Mizutani et al 2017, which may limit the ability to make this correlation. In our two cases of perioperative death with cholecystitis and bacteria detected by FISH, death due to complications of cholecystitis (such as haemodynamic instability) (Amsellem et al 2006, Papazoglou et al 2008) and/or translocation of bacteria from the biliary system and resulting septicaemia could be considered as possible causes.…”

CT attenuation values and mineral distribution can be used to differentiate dogs with and without gallbladder mucoceles

“…Biliary sludge is described in ultrasound as gravity‐dependent echogenic luminal contents without distal acoustic shadowing; the significance is unknown . Recent studies have questioned the role of biliary sludge in the onset of pathology as no direct causation has been found . The clinical implications comparing gallbladder mucoceles and biliary sludge are vastly different.…”

“…Ultrasound is the current standard for diagnosis of gallbladder mucoceles . The appearance of the diseased gallbladder can vary but is typically characterized by radiating or stellate hyperechoic striations within immoveable, hypoechoic gallbladder contents (classically referred to as a “kiwi” pattern) . Pathogenesis of gallbladder mucoceles is unclear and multiple possibilities have been postulated .…”

Association of Gallbladder Mucocele Histologic Diagnosis with Selected Drug Use in Dogs: A Matched Case‐Control Study

“…Surgical removal of the gallbladder carries a good long‐term prognosis for some dogs. However, surgery often is associated with a high mortality rate, with a median 2‐week mortality of 27% (range, 7–45%) 1, 2, 3, 4, 8, 9, 11…”