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择期胆囊切除术治疗犬胆囊疾病的结果

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

作者信息

Youn Gabina, Waschak Michelle J, Kunkel Kevin A R, Gerard Patrick D

出版信息

J Am Vet Med Assoc. 2018 Apr 15;252(8):970-975. doi: 10.2460/javma.252.8.970.

DOI:10.2460/javma.252.8.970
PMID:29595398
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.

摘要

目的 确定接受胆囊切除术的犬只的死亡率以及与未能存活至出院相关的变量。 设计 回顾性队列研究。 动物 2009年至2015年在一家伴侣动物转诊医院因胆道疾病接受胆囊切除术的70只犬。 程序 查阅犬只的病历并收集数据;排除接受胆肠分流手术的犬只。纳入的犬只根据胆囊切除术是否为择期手术(即无或仅有轻微临床症状、无胆道梗阻迹象或最初因其他手术而接受手术的犬只)或非择期手术(即有黄疸且胆道系统通畅情况存疑的犬只)进行分组。比较不同组之间的死亡率(未能存活至出院的犬只比例)。 结果 45只(64%)犬被纳入择期手术组,25只(36%)犬被纳入非择期手术组。两组的死亡率分别为2%(1/45)和20%(5/25),差异显著。总体死亡率为9%(6/70)。未存活犬的血清白蛋白浓度显著低于存活犬,血清丙氨酸氨基转移酶活性和总胆红素浓度显著高于存活犬。有呕吐、嗜睡或厌食迹象、黄疸或氮质血症的犬比没有这些症状的犬存活可能性更低。 结论及临床意义 接受择期胆囊切除术的犬只死亡率比先前报道的要低得多。对于有胆道疾病早期症状的犬,择期胆囊切除术可能是一个合适的建议,以避免与更严重疾病和非择期胆囊切除术相关的更高死亡率。

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