Mayhew Philipp D, Richardson Robert W, Mehler Stephen J, Holt David E, Weisse Chick W
Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, College of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104-6010, USA.
J Am Vet Med Assoc. 2006 Apr 15;228(8):1209-14. doi: 10.2460/javma.228.8.1209.
To determine clinicopathologic features, surgical management, complications, and long-term outcome associated with diseases of the extrahepatic portion of the biliary tract treated via choledochal stent placement in dogs.
Retrospective case series.
13 dogs.
Data were obtained from medical records, and follow-up information was obtained via reexamination or telephone interview with owners or referring veterinarians.
10 dogs had extrahepatic biliary obstruction (EHBO), 6 as a result of pancreatitis. Two dogs had rupture of the common bile duct associated with cholelithiasis. In 1 dog, a stent was placed prophylactically after gastroduodenostomy was performed for a perforated duodenal ulcer. Nine of 13 dogs survived the perioperative period and were discharged. No recurrence of EHBO or other complications developed in the discharged dogs while the stents were in place. Median follow-up period from surgery to last owner contact was 13.3 months. In 1 dog, the stent was removed endoscopically 10 months after surgery and EHBO recurred 9 months after stent removal because of cholangitis. In 4 of 5 dogs that were discharged from the hospital, in which the fate of the stent could be confirmed and the stent was secured to the duodenal wall with absorbable suture materials, the stents were passed in the feces 1 to 11 months after surgery.
Choledochal tube stenting is an effective method of decompression of the extrahepatic portion of the biliary tract in dogs and provides a less complex alternative to traditional cholecystoenterostomy techniques in select cases.
确定通过胆管支架置入术治疗犬肝外胆道疾病的临床病理特征、手术管理、并发症及长期预后。
回顾性病例系列研究。
13只犬。
从病历中获取数据,并通过对主人或转诊兽医进行复查或电话访谈获取随访信息。
10只犬存在肝外胆管阻塞(EHBO),其中6只因胰腺炎所致。2只犬的胆总管破裂与胆结石有关。1只犬在因十二指肠溃疡穿孔行胃十二指肠吻合术后预防性置入支架。13只犬中有9只在围手术期存活并出院。在支架在位期间,出院犬未出现EHBO复发或其他并发症。从手术至最后一次与主人联系的中位随访期为13.3个月。1只犬在术后10个月通过内镜取出支架,取出支架9个月后因胆管炎导致EHBO复发。在5只出院犬中,有4只犬的支架命运得以确认,且支架用可吸收缝合材料固定于十二指肠壁,这些犬的支架在术后1至11个月经粪便排出。
胆管支架置入术是犬肝外胆道减压的有效方法,在某些病例中为传统胆囊肠吻合术提供了一种不太复杂的替代方法。