Han Hyun-Jung, Kim Kyu-Cahng, Yoon Hun-Young
Department of Veterinary Emergency and Critical Care, Konkuk Veterinary Medical Teaching Hospital, Konkuk University, Seoul, South Korea.
Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, Seoul, South Korea.
Front Vet Sci. 2021 Feb 1;8:584975. doi: 10.3389/fvets.2021.584975. eCollection 2021.
A 2.7 kg, 13-year-old, castrated male Yorkshire Terrier was presented with bile peritonitis after cholecystectomy. Exploratory coeliotomy to identify and correct bile leakage revealed that the transected end of the cystic duct was open with no ligatures or vascular clips. The residual cystic duct stump was too short to ligate or seal directly. An autologous rectus sheath graft, harvested from the internal leaf of the rectus sheath, was used to patch the cystic duct stump. The graft was secured over the open duct using several simple interrupted sutures and covered with an omentalization. The clinical signs resolved after surgery, except for a transient increase in hepatobiliary enzyme levels and intrahepatic bile duct dilatation. The enzyme levels returned to near normal on day 25 after surgery. No intrahepatic bile duct dilatation was detected on day 55 after surgery. The owner was contacted for 3 years post-operatively and reported that the dog remained healthy without any long-term complications. Grafting using autologous rectus sheath can be used to treat cystic duct stump leakage that cannot be managed with direct closure using traditional modalities due to spatial constraints.
一只2.7千克、13岁、已去势的雄性约克夏梗犬在胆囊切除术后出现胆汁性腹膜炎。通过剖腹探查以识别和纠正胆汁渗漏，发现胆囊管的横断端开放，没有结扎线或血管夹。残留的胆囊管残端太短，无法直接结扎或封闭。从腹直肌鞘内叶获取的自体腹直肌鞘移植物被用于修补胆囊管残端。使用数针简单间断缝合将移植物固定在开放的胆管上，并覆盖网膜。除了肝胆酶水平短暂升高和肝内胆管扩张外，术后临床症状均得到缓解。术后第25天酶水平恢复至接近正常。术后第55天未检测到肝内胆管扩张。术后3年与主人取得联系，主人报告称该犬保持健康，无任何长期并发症。由于空间限制，对于无法用传统方式直接封闭的胆囊管残端渗漏，使用自体腹直肌鞘移植可用于治疗。
