Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio, USA.
Vet Surg. 2021 May;50(4):784-793. doi: 10.1111/vsu.13632. Epub 2021 Apr 1.
To determine the influence of normograde (NG) versus retrograde (RG) catheterization of the cystic duct and common bile duct (CBD) in dogs with gallbladder mucoceles (GBM) treated with open cholecystectomy.
Retrospective study.
Dogs (n = 117) with GBM.
Medical records were reviewed for signalment, history, clinical laboratory and diagnostic imaging findings, details of surgery including catheterization method, complications, and outcome. Long-term follow-up data were obtained by telephone or electronic communication. Relationships between catheterization method and clinical variables and outcome were evaluated.
Dogs catheterized RG were more likely to experience any postoperative complication (p = .0004) including persistence of gastrointestinal signs (p = .0003). Survival to discharge and long-term survival did not differ by group (p = .23 and p = .49). Total bilirubin (TB) decreased by 70.3% after NG catheterization compared to 39.1% after RG catheterization (p = .03) and increased in 14.9% dogs catheterized NG and 38.0% dogs catheterized RG (p = .004). The presence of a diplomate surgeon at surgery resulted in decreased incidences of any perioperative or postoperative complication (p = .003 and p = .05).
Retrograde catheterization was associated with more postoperative concerns than NG catheterization, but similar survival times. Surgery should be performed by diplomates experienced in biliary surgery to minimize complications.
Although both NG and RG techniques to catheterize the cystic duct and CBD are options for treatment of GBM with low mortality, results of this study provide some evidence to recommend NG over RG catheterization.
确定在接受开放性胆囊切除术治疗的胆囊黏液瘤（GBM）犬中，顺行（NG）与逆行（RG）法胆管囊和胆总管（CBD）置管的影响。
回顾性研究。
GBM 犬 117 只。
回顾性分析了犬的一般信息、病史、临床实验室和诊断影像学结果、手术细节，包括置管方法、并发症和结果。通过电话或电子通讯获得长期随访数据。评估了置管方法与临床变量和结果之间的关系。
RG 置管的犬更有可能发生任何术后并发症（p =.0004），包括胃肠道症状持续存在（p =.0003）。按组比较，存活率和长期存活率无差异（p =.23 和 p =.49）。NG 置管后总胆红素（TB）降低 70.3%，而 RG 置管后降低 39.1%（p =.03），NG 置管的 14.9%犬和 RG 置管的 38.0%犬 TB 增加（p =.004）。手术中有专科医师操作，可降低围手术期或术后任何并发症的发生率（p =.003 和 p =.05）。
逆行置管与 NG 置管相比，术后并发症更多，但生存时间相似。应由具有胆道手术经验的专科医师进行手术，以尽量减少并发症。
尽管 NG 和 RG 两种技术均可用于治疗死亡率较低的 GBM，但本研究结果提供了一些证据，推荐使用 NG 而非 RG 置管。
