Outcome of elective cholecystectomy for the treatment of gallbladder disease in dogs

Abstract

OBJECTIVE To determine mortality rates for dogs undergoing cholecystectomy and variables associated with failure to survive to hospital discharge. DESIGN Retrospective cohort study. ANIMALS 70 dogs that underwent cholecystectomy for biliary tract disease at a companion animal referral hospital from 2009 through 2015. PROCEDURES Medical records of dogs were reviewed and data collected; dogs with biliary diversion surgery were excluded. Included dogs were grouped by whether cholecystectomy had been elective (ie, dogs with no or mild clinical signs, with no indication of biliary obstruction, or that initially underwent surgery for a different procedure) or nonelective (ie, dogs with icterus and questionable patency of the biliary system). Mortality rates (proportions of dogs that failed to survive to hospital discharge) were compared between various groups. RESULTS 45 (64%) dogs were included in the elective group and 25 (36%) in the nonelective group. Group mortality rates were 2% (1/45) and 20% (5/25), respectively, and differed significantly. Overall mortality rate was 9% (6/70). Serum albumin concentration was significantly lower and serum alanine aminotransferase activity and total bilirubin concentration were significantly higher in nonsurviving versus surviving dogs. Dogs with vomiting, signs of lethargy or anorexia, icterus, or azotemia were less likely to survive than dogs without these signs. CONCLUSIONS AND CLINICAL RELEVANCE Dogs that underwent elective cholecystectomy had a considerably lower mortality rate than previously reported. Elective cholecystectomy may be an appropriate recommendation for dogs with early signs of biliary disease to avoid the greater mortality rate associated with more advanced disease and nonelective cholecystectomy.

Impact of intra‐operative hypotension on mortality rates and post‐operative complications in dogs undergoing cholecystectomy

“…This figure is higher than the 1.33% mortality rate previously reported for sick dogs (American Society of Anaesthesiologists (ASAs) classification score 3-5) undergoing general anaesthesia (Brodbelt 2009). Dogs undergoing non-elective cholecystectomy have been reported to have a higher mortality rate (20%) than those undergoing elective surgery (2%) (Youn et al 2018).…”

“…The mortality rate in dogs undergoing cholecystectomy ranges from 21.7 to 40% (Pike et al 2004, Worley et al 2004, Malek et al 2013, Jaffey et al 2018, Youn et al 2018. This figure is higher than the 1.33% mortality rate previously reported for sick dogs (American Society of Anaesthesiologists (ASAs) classification score 3-5) undergoing general anaesthesia (Brodbelt 2009).…”

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

“…Gallbladder mucoceles are life-threatening, commonly requiring immediate cholecystectomy, whereas sludge may require only medical intervention or monitoring. 5,[9][10][11][12][13][14] Ultrasound has been the conventional tool for diagnosis of gallbladder mucoceles and differentiation from biliary sludge; however, with the growing utilization of CT, the appearance of a potentially fatal gallbladder disease is not known.…”

Laparoscopic Cholecystectomy with Single Port Access System in 15 Dogs

“…Short‐term mortality rates between 0% and 5% have been reported after laparoscopic cholecystectomy for nonobstructed gallbladder disease . Elective cholecystectomy with laparotomy has been associated with a mortality rate of 2% . In this study, one dog died after discharge from the hospital due to cholangiohepatitis that was caused by a multidrug‐resistant strain of bacteria.…”