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因胆囊黏液囊肿接受胆囊切除术的犬只的临床发现及预后因素

Clinical findings and prognostic factors for dogs undergoing cholecystectomy for gall bladder mucocele.

作者信息

Malek Sarah, Sinclair Elizabeth, Hosgood Giselle, Moens Noel M M, Baily Trina, Boston Sarah E

机构信息

Department of Companion Animals, Atlantic Veterinary College, University of Prince Edward Island, Canada.

出版信息

Vet Surg. 2013 May;42(4):418-26. doi: 10.1111/j.1532-950X.2012.01072.x. Epub 2013 Jan 17.

Abstract

OBJECTIVE

To report clinical findings and explore prognostic factors for dogs that had cholecystectomy for gall bladder mucocele.

STUDY DESIGN

Retrospective case series.

ANIMALS

Dogs (n = 43) with gall bladder mucoceles.

RESULTS

Diagnosis of gall bladder mucoceles was confirmed by histopathology and 74% were diagnosed based on preoperative abdominal ultrasonography. Intraoperative evidence of gall bladder rupture was noted in 10 dogs (23%), and 16 (37%) had evidence of previous leakage in the abdominal cavity. One dog had positive bacterial growth from the gall bladder content. The most common histopathologic findings in liver biopsies obtained at surgery were cholangiohepatitis, biliary hyperplasia, or cholestasis. Univariate analysis showed evidence of postoperative hypotension (P = .05) to be significantly negatively associated with survival. Significant difference in mean postoperative serum lactate (P = .034) and postoperative packed cell volume (P = .063) between dogs that survived and died was also noted.

CONCLUSIONS

Elevations in postoperative serum lactate concentrations and immediate postoperative hypotension in dogs undergoing cholecystectomy for gall bladder mucoceles are associated with poor clinical outcome.

摘要

目的

报告因胆囊黏液囊肿接受胆囊切除术的犬只的临床发现,并探讨预后因素。

研究设计

回顾性病例系列研究。

动物

患有胆囊黏液囊肿的犬只(n = 43)。

结果

通过组织病理学确诊胆囊黏液囊肿,74%的病例根据术前腹部超声检查确诊。术中发现10只犬(23%)有胆囊破裂迹象,16只犬(37%)有腹腔既往渗漏迹象。1只犬胆囊内容物细菌培养呈阳性。手术时肝脏活检最常见的组织病理学发现为胆管肝炎、胆管增生或胆汁淤积。单因素分析显示术后低血压(P = .05)与生存显著负相关。存活犬与死亡犬术后平均血清乳酸(P = .034)和术后红细胞压积(P = .063)也存在显著差异。

结论

因胆囊黏液囊肿接受胆囊切除术的犬只,术后血清乳酸浓度升高和术后即刻低血压与临床预后不良相关。

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