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Association between biliary tree manipulation and outcome in dogs undergoing cholecystectomy for gallbladder
Hunter J Piegols1, Galina M Hayes2, Samantha Lin3
1Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Objective:
To determine whether catheterization of the common bile duct (CBD) is associated with outcome in dogs undergoing cholecystectomy for gallbladder mucocele and to determine whether this association is modified by the catheterization method.
Study Design:
Multi-institutional retrospective cohort study.
Animals:
Dogs (n = 252) that underwent cholecystectomy for gallbladder mucocele.
Methods:
Dogs were identified via electronic medical record review at four veterinary teaching hospitals. Baseline dog characteristics, surgical findings, and methods including normograde vs retrograde CBD catheterization, intraoperative outcomes, and postoperative outcomes and complications were recorded. Variables were compared between dogs with and without catheterization.
Results:
Catheterized dogs had higher American Society of Anesthesiologists scores (P = .04), higher total bilirubin (P = .01), and were more likely to have dilated CBD at the time of surgery (P < .01). Incidence of major and minor intraoperative complications was similar between the two groups. Surgical time was longer for the catheterized group (P = .01). The overall incidence of postoperative complications was similar between the groups; however, postoperative pancreatitis was associated with performing CBD catheterization (P = .01). This association was retained as an independent association in a multivariable model that addressed baseline group differences (P = .04). Likelihood of developing postoperative pancreatitis was not different between normograde and retrograde catheterization (P = .57).
Conclusion:
Catheterization of the CBD was associated with development of postoperative pancreatitis. This was not influenced by the method of catheterization.
Clinical Significance:
The requirement for catheterization of the CBD during open cholecystectomy in dogs should be carefully considered, particularly in dogs without evidence of biliary obstruction because the procedure may induce postoperative pancreatitis.
