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47 例行腹腔镜胆囊切除术治疗良性胆囊疾病的犬术中胆管造影和胆管冲洗:回顾性分析。

Intraoperative cholangiography and bile duct flushing in 47 dogs receiving laparoscopic cholecystectomy for benign gallbladder disease: A retrospective analysis.

机构信息

Kanai Veterinary Surgery, Himeji, Japan.

Study Group of Small Animal Minimally Invasive Treatment (SAMIT), Himeji, Japan.

出版信息

Vet Surg. 2022 Jul;51 Suppl 1:O150-O159. doi: 10.1111/vsu.13731. Epub 2021 Sep 25.

Abstract

OBJECTIVE

To describe a laparoscopic approach for performing intraoperative cholangiography (IOC) and bile duct flushing (BDF) during laparoscopic cholecystectomy (LC) in dogs. To investigate the clinical outcomes of dogs undergoing these procedures for the treatment of benign gallbladder disease, ie gallbladder mucocele (GM) or cholecystitis.

STUDY DESIGN

Retrospective study.

ANIMALS

Forty-seven client-owned dogs.

METHODS

Medical records of client-owned dogs with benign gallbladder diseases that underwent IOC and BDF during LC between September 2016 and December 2019 were reviewed. Of these dogs, only dogs with GM or cholecystitis were included in the study. The fundus dissection first method was used for LC. Intraoperative cholangiography and BDF procedures were performed laparoscopically using a catheter inserted into the cystic duct following dissection within the subserosal layer of the gallbladder. Videos recorded during each procedure were reviewed, and data on procedure duration, completion, outcome, and technical approach were recorded.

RESULTS

Forty-seven dogs were included in the study. The median procedure time for BDF and IOC was 4 min (range, 2-48 min), and no intraoperative or postoperative complications occurred.

CONCLUSION

During LC, BDF and IOC were performed safely and successfully. Intraoperative cholangiography identified obstructions and strictures in the common bile duct that were not detected using BDF alone.

CLINICAL SIGNIFICANCE

Our findings suggest that BDF and IOC are both safe and time effective and should be considered for routine use by surgeons during LC.

摘要

目的

描述一种在犬腹腔镜胆囊切除术(LC)期间进行术中胆管造影(IOC)和胆管冲洗(BDF)的腹腔镜方法。研究因良性胆囊疾病(即胆囊黏液囊肿(GM)或胆囊炎)而行这些操作的犬的临床结果。

研究设计

回顾性研究。

动物

47 只患宠犬。

方法

回顾 2016 年 9 月至 2019 年 12 月期间在 LC 期间行 IOC 和 BDF 的患宠犬的病历。这些犬中,仅包括 GM 或胆囊炎的犬。采用经胆囊底部浆膜下层切开胆囊后插入胆囊管的方法进行 LC。经腹腔镜进行 IOC 和 BDF 操作。记录每个手术过程的视频,并记录手术持续时间、完成情况、结果和技术方法的数据。

结果

47 只犬纳入研究。BDF 和 IOC 的中位手术时间为 4 分钟(范围,2-48 分钟),无术中或术后并发症发生。

结论

在 LC 期间,BDF 和 IOC 安全且成功地进行。术中胆管造影术发现了单独 BDF 检查未发现的胆总管阻塞和狭窄。

临床意义

我们的研究结果表明,BDF 和 IOC 均安全且有效,应考虑在 LC 期间由外科医生常规使用。

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