Son Tolina T, Thompson Lisa, Serrano Sergi, Seshadri Ravi
Advanced Critical Care, Culver City, CA 90232, USA.
J Vet Emerg Crit Care (San Antonio). 2010 Aug;20(4):426-35. doi: 10.1111/j.1476-4431.2010.00554.x.
To evaluate clinical characteristics and outcomes of cats undergoing surgical intervention in the course of treatment for severe acute pancreatitis.
Retrospective observational study from 2003 to 2007 with a median follow-up period of 2.2 years (range 11 d-5.4 y) postoperatively.
Private referral veterinary center.
Eight cats.
None.
Quantitative data included preoperative physical and clinicopathologic values. Qualitative parameters included preoperative ultrasonographic interpretation, perioperative and intraoperative feeding tube placement, presence of free abdominal fluid, intraoperative closed suction abdominal drain placement, postoperative complications, microbiological culture, and histopathology. Common presenting clinical signs included lethargy, anorexia, and vomiting. Leukocytosis and hyponatremia were present in 5 of 8 cats. Hypokalemia, increased total bilirubin, and hyperglycemia were present in 6 of 8 cats. Elevated alanine aminotransferase and aspartate transferase were present in all cats. Surgery for extrahepatic biliary obstruction was performed in 6 cats, pancreatic abscess in 3 cats, and pancreatic necrosis in 1 cat. Six of the 8 cats survived. Five of the 6 cats that underwent surgery for extrahepatic biliary obstruction and 1 cat that underwent pancreatic necrosectomy survived. All 5 of the cats with extrahepatic biliary obstruction secondary to pancreatitis survived. The 2 nonsurvivors included a cat with a pancreatic abscess and a cat with severe pancreatitis and extrahepatic biliary obstruction secondary to a mass at the gastroduodenal junction. Postoperative complications included progression of diabetes mellitus, septic peritonitis, local gastrostomy tube stoma inflammation, local gastrostomy tube stoma infection, and mild dermal suture reaction.
Cats with severe acute pancreatitis and concomitant extrahepatic biliary obstruction, pancreatic necrosis, or pancreatic abscesses may benefit from surgical intervention. Cats with extrahepatic biliary obstruction secondary to severe acute pancreatitis may have a good prognosis.
评估在严重急性胰腺炎治疗过程中接受手术干预的猫的临床特征及预后。
2003年至2007年的回顾性观察研究，术后中位随访期为2.2年（范围11天至5.4年）。
私立转诊兽医中心。
8只猫。
无。
定量数据包括术前身体和临床病理值。定性参数包括术前超声检查结果、围手术期和术中饲管放置情况、腹腔游离液体的存在情况、术中闭式腹腔引流管放置情况、术后并发症、微生物培养及组织病理学检查。常见的临床表现包括嗜睡、厌食和呕吐。8只猫中有5只出现白细胞增多和低钠血症。8只猫中有6只出现低钾血症、总胆红素升高和高血糖。所有猫均出现丙氨酸转氨酶和天冬氨酸转氨酶升高。6只猫接受了肝外胆管梗阻手术，3只猫接受了胰腺脓肿手术，1只猫接受了胰腺坏死手术。8只猫中有6只存活。接受肝外胆管梗阻手术的6只猫中有5只存活，接受胰腺坏死切除术的1只猫存活。所有5只因胰腺炎继发肝外胆管梗阻的猫均存活。2只死亡猫包括1只患有胰腺脓肿的猫和1只患有严重胰腺炎及因胃十二指肠交界处肿物继发肝外胆管梗阻的猫。术后并发症包括糖尿病进展、化脓性腹膜炎、局部胃造口管造口炎症、局部胃造口管造口感染及轻度皮肤缝线反应。
患有严重急性胰腺炎并伴有肝外胆管梗阻、胰腺坏死或胰腺脓肿的猫可能从手术干预中获益。因严重急性胰腺炎继发肝外胆管梗阻的猫可能预后良好。
