Cleary Kimberly, Chong Wye Li, Angles John M
J Am Vet Med Assoc. 2023 Jul 14;261(11):1694-1701. doi: 10.2460/javma.23.03.0155. Print 2023 Nov 1.
Pancreatitis resulting in extrahepatic biliary obstruction (EHBO) can cause substantial morbidity and mortality. Endoscopic retrograde cholangiopancreatography is utilized for diagnostic and therapeutic purposes in humans; however, this is not available in veterinary medicine. Treatment options include medical management and biliary drainage procedures. The aim of this study was to describe the management of EHBO secondary to pancreatitis in dogs, treated medically and surgically and to determine whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) differ between the treatment groups.
41 dogs treated for EHBO secondary to pancreatitis during the period of May 2015 to November 2021.
Records from 41 dogs diagnosed with EHBO secondary to pancreatitis were reviewed, and information extracted included clinical signs, ultrasound findings, NLR, PLR, histopathology, treatment, and outcomes.
18 of 19 (95%) surgical patients survived, while 12 of 21 (57%) medical patients survived. There was no difference in the length of hospitalization or time to return to adequate function between the groups; however, there was a significant difference in the 2- and 12-month survival between those treated surgically and medically. There was no difference in the NLR or PLR between surgically versus medically treated dogs or between survivors and nonsurvivors.
The mortality rate of surgery for EHBO secondary to pancreatitis may be lower than previously described, and in this cohort of dogs, those treated surgically had improved survival at 2 and 12 months compared to those treated medically.
导致肝外胆管梗阻(EHBO)的胰腺炎可引起严重的发病率和死亡率。内镜逆行胰胆管造影术用于人类的诊断和治疗;然而,这在兽医学中并不适用。治疗选择包括药物治疗和胆管引流手术。本研究的目的是描述犬胰腺炎继发EHBO的药物和手术治疗管理,并确定治疗组之间的中性粒细胞与淋巴细胞比率(NLR)和血小板与淋巴细胞比率(PLR)是否存在差异。
2015年5月至2021年11月期间因胰腺炎继发EHBO接受治疗的41只犬。
回顾41只被诊断为胰腺炎继发EHBO的犬的记录,提取的信息包括临床症状、超声检查结果、NLR、PLR、组织病理学、治疗方法和预后。
19只手术治疗的犬中有18只(95%)存活,而21只药物治疗的犬中有12只(57%)存活。两组之间的住院时间或恢复正常功能的时间没有差异;然而,手术治疗和药物治疗的犬在2个月和12个月的生存率存在显著差异。手术治疗与药物治疗的犬之间或存活者与非存活者之间的NLR或PLR没有差异。
胰腺炎继发EHBO的手术死亡率可能低于先前描述的,在这组犬中,与药物治疗的犬相比,手术治疗的犬在2个月和12个月时的生存率有所提高。