CT cholangiography in dogs with gallbladder mucocoele

Hayakawa, Soichiro; Sato, Keita; Sakai, Manabu; Kutara, Kenji; Asano, Kazushi; Watari, Toshihiro

doi:10.1111/jsap.12832

Cited by 13 publications

(29 citation statements)

References 29 publications

(36 reference statements)

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“…1,6,12,16,18 Patency of the cystic duct and CBD can be determined by surgical catheterization and flushing of the ducts to remove material obstructive to bile flow. 1,6,[9][10][11][12]16,[19][20][21][22][23][24][25] Flushing of the cystic duct and CBD can be accomplished by normograde (NG) or retrograde (RG) catheterization. 6,[9][10][11][12]16,20,25 Normograde catheterization requires removal of GB contents via cholecystotomy or cholecystectomy prior to catheterization.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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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,

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Section: Introductionmentioning

confidence: 99%

“…Cholecystectomy addresses the defective GB wall and is the most appropriate treatment for GBM 1,6,12,16,18 . Patency of the cystic duct and CBD can be determined by surgical catheterization and flushing of the ducts to remove material obstructive to bile flow 1,6,9‐12,16,19‐25 …”

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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“…Gall bladder mucoceles can cause bile duct obstruction, a lifethreatening emergency that can cause a number of sequelae, including but not limited to gall bladder rupture, bile peritonitis, cholecystitis, acute renal failure, multisystem organ failure and death (Amsellem et al 2006;Hayakawa et al 2018, Mehler et al 2004Pike et al 2004;Rogers et al 2020, Smalle et al 2015Wennogle et al 2019;Youn et al 2018). A gall bladder mucocele is defined as a mucus-filled distension of the gall bladder and can lead to gall bladder or common bile duct wall necrosis and subsequent rupture (Worley et al 2004, Malek et al 2013, Smalle et al 2015.…”

Section: Introductionmentioning

confidence: 99%

Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles

Friesen

Upchurch

Hollenbeck

et al. 2021

J of Small Animal Practice

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The purpose of this study was to describe elective and nonelective post-cholecystectomy complications and mortality rates in dogs with a gall bladder mucocele. The secondary purpose was to report complications and mortality rates for different methods of common bile duct catheterisation.Materials and MethOds: A multi-institutional retrospective case series was performed to identify dogs with a gall bladder mucocele between 2004 and 2018 that underwent a cholecystectomy. Dogs were classified into nonelective or elective based on the presence or absence, respectively, of gall bladder rupture, biliary duct distension, clinical signs or hyperbilirubinemia. Each cholecystectomy was classified into three groups: duodenotomy and retrograde catheterisation, normograde catheterisation or no catheterisation. Complications were divided into four grades based on increasing severity and mortality rates were assessed for each. results: The mortality rate was 2 (6%) out of 31 for dogs undergoing an elective cholecystectomy and 21 (23%) out of 90 for dogs undergoing a nonelective cholecystectomy. The complication rate was 52% for the elective cholecystectomy and 50% for nonelective cholecystectomy. The majority of the complications in the elective category were grade 1 (mild). Post-operative hyperthermia developed in 35% of dogs that had a duodenotomy and retrograde common bile duct catheterisation, in 4% of dogs with a normograde common bile duct catheterisation and in 7% of dogs that did not have the common bile duct catheterised. clinical significance: Elective cholecystectomy in dogs with a gall bladder mucocele in this study carried a low mortality rate and a relatively high frequency of minor complications.

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“…Although mucoceles are readily detected using ultrasonography, relative to CT, it can result in longer scan times, greater patient discomfort from physical compression of the ultrasound probe, and incomplete evaluation of the abdomen in large patients . Thus, CT could allow faster and more complete abdominal evaluation for these patients, but scientific investigation of canine biliary contents in veterinary medicine using CT is minimal . Computed tomography is becoming a more accessible tool and, in some instances, a first choice diagnostic modality for larger dogs .…”

Section: Introductionmentioning

confidence: 99%

“…20 Thus, CT could allow faster and more complete abdominal evaluation for these patients, but scientific investigation of canine biliary contents in veterinary medicine using CT is minimal. 21 Computed tomography is becoming a more accessible tool and, in some instances, a first choice diagnostic modality for larger dogs. 20,22 The ability of CT to distinguish between canine gallbladder sludge and mucoceles is unknown.…”

Section: Introductionmentioning

confidence: 99%

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

Fuerst

Hostnik

2019

Vet Radiology Ultrasound

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Gallbladder mucoceles are potentially fatal in dogs. Multiphase CT angiography was performed to evaluate the canine gallbladder in three conditions: no sludge, sludge occupying ≥25% of the lumen, and mucoceles. Twenty dogs with normal hepatobiliary bloodwork and no‐to‐minimal gallbladder sludge, 13 dogs with normal bloodwork and ≥25% sludge in the gallbladder lumen, and 18 dogs with histologically confirmed gallbladder mucoceles were enrolled in a prospective, observational diagnostic accuracy study. Three regions of interest (ROI) were stratified in the dorsal‐ventral orientation and a single ROI was measured within the hepatic parenchyma. Mean attenuation and presence of mineral were recorded. Average Hounsfield units (HU) were recorded for precontrast, arterial, portovenous, and late venous phases. The overall median HU value for mucoceles was significantly higher than gallbladders without sludge and with sludge; precontrast median overall attenuation was 49.3, 35.8, and 39.7 HU, respectively (P < .000004). Mineral was seen in four (20%) dogs with no sludge, seven (56%) dogs with sludge, and nine (50%) dogs with mucoceles. Mineral in the dogs with mucoceles was located within the central aspect of the gallbladder lumen in 67% of mucoceles; this mineral distribution was not seen in any dog without a mucocele. Computed tomography can differentiate a subset of gallbladder mucoceles from dogs with and without gallbladder sludge, especially in the precontrast series. An HU value of 48.6 is 52% sensitive and 96% specific for a gallbladder mucocele. A hyperattenuating gallbladder on precontrast CT images and centrally distributed mineral can be a gallbladder mucocele.

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CT cholangiography in dogs with gallbladder mucocoele

Abstract: CT cholangiography delineates the structural characteristics of the biliary system and partially estimates its patency in dogs with gallbladder mucocoele. Therefore this procedure may be useful as a preoperative screen of the bile duct system in dogs with gallbladder mucocoele.

Cited by 13 publications

References 29 publications

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

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

Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles

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

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