Long-Term Outcome after Cholecystectomy without Common Bile Duct Catheterization and Flushing in Dogs

Abstract

The aim of this study is to report outcomes of dogs undergoing cholecystectomy for gall bladder mucocele (GBM) without flushing and catheterization of the common bile duct (CBD). This is a retrospective multicentric study from three veterinary referral hospitals and included 82 dogs diagnosed with GBM. Medical records were reviewed for clinical and histopathological findings. Long-term outcome was assessed with an owner questionnaire. The common bile duct was considered normal (<4 mm), mildly dilated (5–6 mm) and moderately dilated (>7 mm) in 88%, 10% and 2.4% of dogs, respectively. Surgery was uncomplicated in 83% of dogs. Intraoperative complications were recorded in 21% of dogs, with hypotension being the most common, whereas postoperative complications were documented in 20% of dogs, with vomiting/regurgitation being the most common. Ninety-six percent of dogs that underwent cholecystectomy in this study survived to discharge. Follow-up ranged from 142 to 3930 days (median: 549 days). Eighty-five percent of dogs were alive at the time of follow-up. Dogs undergoing cholecystectomy for GBM without catheterization and flushing of the CBD have a favourable prognosis for recovery and quality of life.

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

“…Catheterization and flushing of the CBD before cystic duct ligation have been proposed to reduce the risk of postoperative compromised bile flow from choleliths or residual bile plugs and to ensure CBD patency [ 3 , 28 , 29 ]. Nevertheless, the need for intraoperative catheterization during cholecystectomy is still controversial [ 4 ]. The routine flushing of the CBD in patients with GBM may not be beneficial and may even lead to associated morbidity.…”

“…Generally, catheterization and flushing of the biliary ducts, accomplished by normograde or retrograde techniques, are proposed to ensure patency [ 3 ]. However, intraoperative catheterization remains controversial because of the risk of iatrogenic damage to the biliary tract and prolonged surgical time [ 4 , 5 ].…”

“…n, Number of patients; BW, bodyweight; ALT, alanine transaminase; AST, aspartate transaminase; ALP, alkaline phosphatase; GGT, gamma-glutamyl transferase; T.bil, Total bilirubin.Reference ranges are as follows: Total cholesterol; triglycerides; ALT; AST; ALP; GGT[1][2][3][4][5][6][7][8][9][10]; and T.bil [0.1-0.5]. *p<0.05 https://doi.org/10.1371/journal.pone.0300395.t001…”