Influence of normograde versus retrograde catheterization of bile ducts in dogs treated for gallbladder mucocele

Abstract

Objective: To determine the influence of normograde (NG) versus retrograde (RG) catheterization of the cystic duct and common bile duct (CBD) in dogs with gallbladder mucoceles (GBM) treated with open cholecystectomy.Study design: Retrospective study. Animals: Dogs (n = 117) with GBM.Methods: Medical records were reviewed for signalment, history, clinical laboratory and diagnostic imaging findings, details of surgery including catheterization method, complications, and outcome. Long-term follow-up data were obtained by telephone or electronic communication. Relationships between catheterization method and clinical variables and outcome were evaluated.Results: Dogs catheterized RG were more likely to experience any postoperative complication (p = .0004) including persistence of gastrointestinal signs (p = .0003). Survival to discharge and long-term survival did not differ by group (p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization (p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG (p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication (p = .003 and p = .05). Conclusion: Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications.Clinical significance: Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality,

Ultrasonographic patterns, clinical findings, and prognostic variables in dogs from Asia with gallbladder mucocele

“…Gallbladder rupture was identified in 26% (22/85) of dogs undergoing cholecystectomy in this study, similar to several recent studies (19%‐38%) 2,5,7,8 . Identification of gallbladder rupture was significantly associated with in‐hospital death on univariable screening but lost significance when adjusted for in the multivariable model in this study.…”

“… 1 , 2 , 3 , 4 Surgical intervention to remove the gallbladder has an approximate in‐hospital death rate of 20% (range, 7%‐31%). 2 , 5 , 6 , 7 , 8 The specific disease etiology of GBM remains unknown; however, affected dogs have a high incidence of concurrent endocrinopathies and hyperlipidemia. 9 , 10 Further, the disease is over‐represented in purebred dogs such as Shetland sheepdog, border terrier, miniature schnauzer, and beagles.…”

“…Gallbladder rupture is a relatively common complication of GBM occurring in approximately 25% (range, 19%‐38%) of dogs with signs of biliary tract disease. 2 , 5 , 7 , 8 , 15 There are conflicting reports regarding the clinical importance of gallbladder rupture in dogs with GBM. A recent large, retrospective study found that the presence of gallbladder rupture in dogs with GBM that had a cholecystectomy was associated with in‐hospital death.…”

“…It is characterized by gallbladder epithelial mucus hypersecretion and hypokinesia that can result in emergent clinical disease associated with extrahepatic bile duct obstruction, cholecystitis (sterile or infectious), biliary rupture, and systemic inflammatory response syndrome 1‐4 . Surgical intervention to remove the gallbladder has an approximate in‐hospital death rate of 20% (range, 7%‐31%) 2,5‐8 . The specific disease etiology of GBM remains unknown; however, affected dogs have a high incidence of concurrent endocrinopathies and hyperlipidemia 9,10 .…”

“…Gallbladder rupture is a relatively common complication of GBM occurring in approximately 25% (range, 19%‐38%) of dogs with signs of biliary tract disease 2,5,7,8,15 . There are conflicting reports regarding the clinical importance of gallbladder rupture in dogs with GBM.…”