Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Cornell University Hospital for Animals, Ithaca, New York.
Vet Surg. 2021 May;50(4):767-774. doi: 10.1111/vsu.13542. Epub 2020 Nov 23.
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.
Multi-institutional retrospective cohort study.
Dogs (n = 252) that underwent cholecystectomy for gallbladder mucocele.
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.
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).
Catheterization of the CBD was associated with development of postoperative pancreatitis. This was not influenced by the method of catheterization.
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.
确定在因胆囊黏液囊肿而行胆囊切除术的犬中，行胆总管（CBD）置管是否与结局相关，并确定这种相关性是否因置管方法而异。
多机构回顾性队列研究。
因胆囊黏液囊肿而行胆囊切除术的犬（n=252）。
通过在四家兽医教学医院的电子病历回顾来识别犬。记录了基线犬特征、手术发现以及包括顺行与逆行 CBD 置管在内的方法、术中结果、术后结果和并发症。比较了置管与未置管犬之间的变量。
置管犬的美国麻醉师协会评分更高（P=0.04）、总胆红素更高（P=0.01），并且在手术时 CBD 更可能扩张（P<0.01）。两组间主要和次要术中并发症的发生率相似。置管组的手术时间更长（P=0.01）。两组间的总体术后并发症发生率相似；然而，CBD 置管与术后胰腺炎相关（P=0.01）。在解决基线组间差异的多变量模型中，该关联仍为独立关联（P=0.04）。顺行和逆行置管之间发生术后胰腺炎的可能性无差异（P=0.57）。
CBD 置管与术后胰腺炎的发生相关。这不受置管方法的影响。
在开腹胆囊切除术时，应仔细考虑 CBD 置管的必要性，尤其是在没有胆道梗阻证据的犬中，因为该操作可能会诱发术后胰腺炎。
