Extrahepatic Biliary Tract Obstruction

Mehler, Stephen J.; Mayhew, Philipp D.

doi:10.1002/9781118997505.ch47

Cited by 6 publications

(8 citation statements)

References 93 publications

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“…In this clinical case, the remarkable dilatation of the biliary tract made this surgery possible. The authors decided to combine these two surgical techniques to obtain immediate and effective bile flow decompression 27,28 . End‐to‐end anastomosis of the common bile duct is rarely applied in dogs and cats due to the small size of the common bile duct.…”

Section: Discussionmentioning

confidence: 99%

“…The authors decided to combine these two surgical techniques to obtain immediate and effective bile flow decompression. 27,28 End-to-end anastomosis of the common bile duct is rarely applied in dogs and cats due to the small size of the common bile duct. However, in 97% of cats with obstructed common bile ducts, the diameter of the common bile duct is over 5 mm 2 .…”

Section: Tumour Location Is Essential In Determining Adequate Treatme...mentioning

confidence: 99%

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End‐to‐end anastomosis of the common bile duct and cholecystoduodenostomy for the treatment of extrahepatic cholangiocarcinoma in an 11‐year‐old cat

Jifcovici

Caraty²,

Vincken³

et al. 2021

Vet Record Case Reports

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An 11-year-old cat presented with a 10-day history of anorexia and jaundice. Diagnostic examinations showed hyperbilirubinemia, dilatation of the bile ducts and a mural mass in the common bile duct. Cholecystoduodenostomy, mass resection and end-to-end anastomosis of the common bile duct were performed. Histopathology revealed a well-differentiated cholangiocarcinoma. The cat improved clinically and had a good quality of life for 16 months prior to disease recurrence. Liver biopsy indicated metastasis of the primary tumour. Euthanasia was elected. Cholangiocarcinoma in cats is considered to have a poor prognosis with high rate of metastasis. Given the paucity of information in the veterinary literature and the lack of specific prognostic indicators, guidelines for feline cholangiocarcinoma management have not been fully established. This clinical case report describes an acceptable outcome after tumour resection and biliary diversion in an 11-year-old cat with extrahepatic cholangiocarcinoma and no pre-existing metastases. INVESTIGATIONSAbdominal ultrasound (US) indicated severe generalized hepatomegaly with multiple tubular/round, anechoic structures

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Section: Discussionmentioning

confidence: 99%

Section: Tumour Location Is Essential In Determining Adequate Treatme...mentioning

confidence: 99%

End‐to‐end anastomosis of the common bile duct and cholecystoduodenostomy for the treatment of extrahepatic cholangiocarcinoma in an 11‐year‐old cat

Jifcovici

Caraty²,

Vincken³

et al. 2021

Vet Record Case Reports

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“…In addition, cases in which methods other than anterograde catheterization were used or the flushing method was not clearly described in the surgical record were also excluded. The criteria for elective or nonelective surgery were similar to those used in previous studies [ 16 ]. Surgery performed to prevent future complications related to gallbladder mucocele while the patient’s condition was stable was classified as elective surgery.…”

Section: Methodsmentioning

confidence: 99%

Clinical Outcomes in Dogs Undergoing Cholecystectomy via a Transverse Incision: A Meta−Analysis of 121 Animals Treated between 2011 and 2021

Chae

Jeong²,

Lee

et al. 2023

Veterinary Sciences

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Although many studies have been conducted on the use of median and transverse incisions in various surgeries in the field of human medicine, related studies in veterinary medicine are lacking. This study aimed to present treatment options for dogs requiring cholecystectomy by reporting the pros and cons of 121 cholecystectomies performed via transverse incision at our hospital over 10 years. In most included cases, nonelective cholecystectomy was performed in an unstable emergency situation. The perioperative mortality rate was 23.14%, which was not significantly different from that of cholecystectomy performed via the conventional midline approach. However, the overall operation time (46.24 ± 6.13 min; range 35–65 min) was shortened by securing an adequate surgical field of view. The transverse incision approach facilitates fast and accurate surgery without increasing the fatality rate in small-breed dogs, in whom securing an adequate surgical field of view is difficult. Thus, transverse incision should be actively considered in dogs undergoing cholecystectomy due to emergency conditions, such as bile leakage or biliary tract obstruction, since prolonged anesthesia can be burdensome. This study may improve cholecystectomy outcomes in small-breed dogs with difficult-to-secure surgical fields.

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“…6,14,15 Factors associated with increased mortality include intraoperative and postoperative hypotension, hypoalbuminemia, elevated GGT, azotemia, elevated ALP, septic bile peritonitis, and hypoglycemia. 5,7,14,16,17 Complications associated with these procedures include hemorrhage, stricture of the stoma, chronic ascending cholangitis, stent occlusion, premature stent migration, biofilm formation, and gastric ulceration. 6,9,[17][18][19][20] In the literature reviewed, red-rubber latex or plastic stents were the most commonly used stent in veterinary medicine for EHBO.…”

Section: Introductionmentioning

confidence: 99%

“…These procedures are associated with high mortality rates (7%–64% in dogs and 22%–100% in cats) with techniques in veterinary medicine described recently 6,14,15 . Factors associated with increased mortality include intraoperative and postoperative hypotension, hypoalbuminemia, elevated GGT, azotemia, elevated ALP, septic bile peritonitis, and hypoglycemia 5,7,14,16,17 . Complications associated with these procedures include hemorrhage, stricture of the stoma, chronic ascending cholangitis, stent occlusion, premature stent migration, biofilm formation, and gastric ulceration 6,9,17–20 …”

Section: Introductionmentioning

confidence: 99%

Clinical use of uncovered balloon‐expandable metallic biliary stents for treatment of extrahepatic biliary tract obstructions in cats and dogs: 11 cases (2012–2022)

Bergen,

Travis,

Pike

2023

Veterinary Surgery

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ObjectiveTo describe the application of uncovered balloon‐expandable metallic biliary stents for treatment of extrahepatic biliary obstructions (EHBOs) and the outcomes for dogs and cats treated for EHBO with this technique.Study designRetrospective single institutional study.AnimalsEight dogs and three cats treated at the Veterinary Specialty Hospital of San Diego for EHBO between January 2012 and February 2022.MethodsData collected from the medical records included signalment, presenting complaint, laboratory and imaging findings, surgical findings, hospitalization time, complications, and follow‐up information.ResultsMedian duration of short‐term follow up was 16 days (6–45 days). Improved biochemical abnormalities and resolution of clinical signs were recorded in 10/11 cases. Two dogs died within 2 weeks of surgery. One dog developed systemic inflammatory response syndrome 5 days postoperatively and was euthanized; the cause of death in the second case was unknown. Long‐term follow up was available in seven cases, with a median duration of 307.5 days (62–2268 days). Bile‐duct patency was maintained for at least 356–622 days (median: 446 days) in three cats and 62–2268 days (median: 650.5 days) in four dogs with long‐term follow up available. One cat had recurrent obstruction with choledocholiths 446 days postoperatively. One stent was removed 614 days postoperatively due to recurrent cholangiohepatitis.ConclusionUncovered balloon‐expandable metallic biliary stents were placed successfully and relieved EHBO in all cases that survived to discharge.Clinical significanceUse of uncovered balloon‐expandable metallic biliary stents should be considered as an alternative to temporary choledochal luminal stenting or cholecystoenterostomy to manage EHBO.

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Extrahepatic Biliary Tract Obstruction

Cited by 6 publications

References 93 publications

End‐to‐end anastomosis of the common bile duct and cholecystoduodenostomy for the treatment of extrahepatic cholangiocarcinoma in an 11‐year‐old cat

End‐to‐end anastomosis of the common bile duct and cholecystoduodenostomy for the treatment of extrahepatic cholangiocarcinoma in an 11‐year‐old cat

Clinical Outcomes in Dogs Undergoing Cholecystectomy via a Transverse Incision: A Meta−Analysis of 121 Animals Treated between 2011 and 2021

Clinical use of uncovered balloon‐expandable metallic biliary stents for treatment of extrahepatic biliary tract obstructions in cats and dogs: 11 cases (2012–2022)

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