Initial experience with endoscopic retrograde cholangiography and endoscopic retrograde biliary stenting for treatment of extrahepatic bile duct obstruction in dogs

Abstract

ERC and endoscopic retrograde biliary stenting were successfully performed in a small group of healthy dogs and 1 patient with EHBDO, but were technically challenging procedures. Further investigation of this minimally invasive technique for the treatment of EHBDO in dogs is necessary before this may be considered a viable alternative to current treatment methods.

Diagnostic Value of Endoscopic Retrograde Cholangiopancreatography and Therapeutic Value of Endoscopic Sphincterotomy in Dogs With Suspected Hepatobiliary Disorders

“…Only four of nine dogs showed clinical and laboratory improvement after EST. This nding is similar to the ndings of previous studies reporting clinical improvement after EST in a dog with papillary stenosis [9] and in one dog with signs of extrahepatic duct obstruction treated by EST and biliary stenting [10].…”

“…As established in human medicine, endoscopic treatment should include biliary stenting when diagnosing distal or long CBD strictures by MRCP or ERC, especially with malignant lesions that are not eligible for open surgery [31]. Endoscopic CBD stenting has been proven possible in dogs [10]. It is very likely that the establishment of MRCP in the diagnostic work up of dogs with suspected disorders of the biliary duct system could give a better indication and a more successful outcome of endoscopic interventions [4].…”

“…Ultrasonography (US) is the most commonly used non-invasive imaging modality in the evaluation of the hepatobiliary system and the exocrine pancreas in dogs, offering high sensitivity but often lacking speci city, especially in patients with biliary and pancreatic ductal problems [4]. Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be an applicable, direct technique for evaluating hepatobiliary and pancreatic disorders both in human and veterinary medicine [5,6,7,8,9,10]. It is a minimally invasive technique, which combines endoscopy and uoroscopy to image the biliary system (endoscopic retrograde cholangiography, ERC) and pancreatic duct (endoscopic retrograde pancreatography, ERP).…”

“…In veterinary medicine, the feasibility of diagnostic ERCP in dogs with and without chronic gastrointestinal disorders [5,9] and in healthy cats [8] has been demonstrated. In 2015, Berent et al reported successful endoscopic biliary stenting in 5/7 healthy dogs and in 1/2 dogs with extrahepatic bile duct obstruction [10]. However, the e cacy and safety of diagnostic and therapeutic ERCP has not been evaluated in the veterinary literature to date.…”

Bile duct obstruction associated with pancreatitis in 46 dogs

“…Biliary decompression can be achieved with percutaneous ultrasound-guided cholecystocentesis, endoscopic retrograde biliary stenting, or surgical intervention, such as cholecystoduodenostomy or choledocal stent placement. [8][9][10] Surgery of the biliary tract carries substantial risk in dogs with pancreatitis, with a case fatality rate of 50% in dogs. 11 Complications associated with cholecystocentesis are uncommon but can include bile peritonitis and cardiorespiratory arrest.…”