The effect of flushing of the common bile duct on hepatobiliary markers and short‐term outcomes in dogs undergoing cholecystectomy for the management of gall bladder mucocele: A randomized controlled prospective study

Abstract

Objective To determine the effect of flushing of the common bile duct (CBD) on hepatobiliary markers and short‐term outcome in dogs undergoing cholecystectomy for the management of gallbladder mucocele (GBM). Study design Randomized, controlled, prospective study. Animals Thirty‐two client‐owned dogs. Methods Dogs were allocated randomly to either a “flush” group or a “non‐flush group.” Flushing was performed in a normograde fashion, followed by a routine cholecystectomy. Data collected included presenting clinical signs, preoperative and 3‐day postoperative hepatobiliary markers (alkaline phosphatase, ALP; alanine aminotransferase, ALT; gamma glumatyl‐transferase, GGT; bilirubin; cholesterol; triglycerides), duration of hospitalization, and complications. These data were compared between groups. Results Sixteen dogs were enrolled in each group. One dog (in the flush group) was excluded following diagnosis of hepatic lymphoma. Border terriers were overrepresented (20/31). Overall, there were marked reductions from preoperative to 3 days postoperative in serum bilirubin (p = .004), ALP (p = .020), ALT (p < .001), GGT (p = .025), and cholesterol (p < .001) values. There was no difference in any marker between groups. Survival to discharge was 90.3% (28/31 dogs). Conclusion Cholestatic markers decreased significantly 3 days postcholecystectomy. No short‐term clinical or clinico‐pathological benefits were identified when flushing the CBD in dogs undergoing cholecystectomy for GBM. Clinical significance The findings of the study do not support routine flushing of the CBD during cholecystectomy for GBM in dogs.

Determining the patency of biliary tracts in dogs with gallbladder mucocele using near-infrared cholangiography with indocyanine green

“…Acute pancreatitis carries a high mortality rate in veterinary medicine, emphasizing the clinical significance of this complication [ 30 ]. Previous studies have shown that CBD catheterization, regardless of the approach, can increase surgical time without significant postoperative bilirubin level improvement [ 31 , 32 ]. This suggests that CBD flushing may lead to the reflux of biliary secretions into the pancreatic duct, potentially causing pancreatitis, or result in trauma to the major duodenal papilla, leading to inflammation and temporary occlusion of the pancreatic duct orifice.…”

MUC5AC and MUC5B expression in canine gallbladder mucocele epithelial cells

“…Thus, although elevated MUC1 expression may not be a direct factor in mucus accumulation, it may have an indirect effect on the pathophysiology of GBM. To investigate the relationship between the severity of GBM and the expression level of MUC1, we examined the correlation between MUC1 gene expression and blood test markers related to the outcome of GBM cases such as total bilirubin, C-reactive protein, alkaline phosphatase, and alanine aminotransferase [ 4 , 13 , 15 ], but none of the correlations between these markers and MUC1 were significant (data not shown). Further studies to examine the protein expression level of MUC1 in gallbladder epithelial cells of animals with GBM and the influence of increased expression of MUC1 on GBM are needed.…”