Percutaneous Ultrasound‐Guided Cholecystocentesis in Healthy Cats

Abstract

Percutaneous ultrasound-guided cholecystocentesis (PUC) is a minimally invasive technique for bile collection that is used successfully in human patients with cholecystitis. Its use in veterinary medicine for evaluation of hepatobiliary disorders has been limited because of the perceived unacceptable risk of bile peritonitis. An experimental study was conducted to evaluate the safety and efficacy of PUC, to collect data on bile cytology and bacteriologic culture, and to attempt to isolate Helicobacter spp. from the bile of healthy cats. In fasted and sedated cats, PUC was performed with a 22-gauge 1.5-in. (3.81 cm) needle with an attached 12-mL syringe via a right-sided transhepatic approach (n ϭ 1) or into the fundus of the gallbladder (n ϭ 11) via a right ventral abdominal approach. An attempt was made to completely empty the gallbladder. A small amount of abdominal effusion, consistent with bile or blood, was seen ultrasonographically immediately after aspiration in the 1st cat. Ultrasonographic complications with the 2nd technique were not observed in the remaining 11 cats. Decreased appetite and evidence of mild abdominal pain were detected in 4 cats within 2 days after PUC. The mean neutrophil count increased 2 days after PUC (P Ͻ .01) but remained within the reference range. The bile was acellular in 11 of 12 cats, and aerobic, anaerobic, and Helicobacter spp. cultures yielded no growth in 12 of 12 cats. There were no remarkable gross or histologic lesions of abdominal organs at the postmortem examination (8 cats) performed 7-8 days after the procedure. PUC appears to be a safe and technically simple procedure. Further studies are warranted to determine the use and safety of PUC in cats with hepatobiliary diseases.

Percutaneous Ultrasound‐guided Cholecystocentesis and Bile Analysis for the Detection ofPlatynosomumspp.‐Induced Cholangitis in Cats

“…The volume of bile collected (3 mL; IQR: 1.95 mL; 5.8 mL) was considered sufficient to perform diagnostic testing, including bile egg count, and aerobic and anaerobic cultures. In healthy cats, the mean volume of bile collected by PUC has been reported to be 1.8 ± 0.8 mL (range 0.9–3 mL) . In a report describing acute cholecystitis in 3 cats, the volume of bile collected by PUC was 1–2 mL …”

“…Escherichia coli infection was identified in 46% of the cats in which bile was submitted (13 cats) for bacteriologic culture. Bile in healthy cats is sterile . Enterobacteriaceae organisms are postulated to originate from the proximal duodenum, and inoculated by retrograde infection of the biliary tree by migrating flukes.…”

“…Percutaneous ultrasound‐guided cholecystocentesis is considered a safe, minimally invasive, and technically simple procedure in healthy cats . However, concerns have been raised about its safety in cats with cholangitis and specifically when there is disease of the gallbladder .…”

Liver

“…185,209,[231][232][233] Both transhepatic and direct fundic (transperitoneal) approaches to the gallbladder have been reported. 185,209,[231][232][233] Both transhepatic and direct fundic (transperitoneal) approaches to the gallbladder have been reported.…”

Fine needle biopsy of abdominal organs in dogs – indications, contraindications and performance technique

“…An indication for the gall bladder FNAB is also its decompensation in animals with extra liver biliary ducts obstruction (Iton 1984). In this case the Fine needle biopsy of abdominal organs in dogs...gall bladder should be maximally emptied during a puncture, which reduces the risk of bile leak to the peritoneal cavity and development of bile derivative hepatitis and peritonitis (Itoh 1984, Dodd et al 1996, Das et al 1997, Vörös et al 2002, Savary-Bataille et al 2003, Herman et al 2005. An indication for the gall bladder FNAB can also be suspicion of a neoplastic process.…”