Speelman Jonathan P, Hui Ki-Lam, Woodbridge Nicolas T, Pfeiffer Susanne, Beatty Julia A, Taylor Alan H
Advanced Vetcare, 2 Chandler Hwy, Kew, Melbourne, VIC 3101, Australia.
Pulse Veterinary Specialists and Emergency, 450 Ordze Road, Sherwood Park, AB T8B 0C5, Canada.
Vet Sci. 2024 Nov 29;11(12):610. doi: 10.3390/vetsci11120610.
Surgical management of feline extra-hepatic biliary obstruction (EHBO) has poor survival rates with few prognostic factors reported in the literature. The etiology and clinical findings of feline EHBO and their influence on short-(2 weeks-6 months) and long-term (>6 months) survival and prognosis were examined in an observational clinical retrospective study of 26 client-owned cats undergoing surgery for biliary obstruction at one institution between 2012 and 2020. The etiology of EHBO was determined in 21/26 cats, which included inflammatory causes (14/21), neoplastic causes (6/21), and a duodenal foreign body (1/21). Pre-operative hyperbilirubinemia and post-extubation hypotension (mean arterial pressure < 60 mmHg) were statistically associated with reduced short- and long-term survival. Short-term survival was documented in 17/26 cats, and long-term survival in 13/26 cats. Median survival time (MST) was 86 days (range, 0-1497). An MST of 17 days (range, 2-520) in cats with malignancies was found compared to an MST of 1165 days (range, 61-2268) in EHBO resulting from inflammatory complexes. Pre-operative hyperbilirubinemia and immediate post-operative hypotension may represent prognostic factors for cats undergoing surgery for EHBO. Cats with inflammatory causes of EHBO carry a more favorable prognosis than neoplastic causes. Further studies are required to evaluate the validity of the observed associations.
猫肝外胆管阻塞（EHBO）的手术治疗生存率较低，文献中报道的预后因素较少。在一项观察性临床回顾性研究中，对2012年至2020年期间在一家机构接受胆管阻塞手术的26只宠物猫进行了检查，以探究猫EHBO的病因、临床症状及其对短期（2周 - 6个月）和长期（>6个月）生存及预后的影响。26只猫中确定了21只猫的EHBO病因，其中包括炎症性病因（14/21）、肿瘤性病因（6/21）和十二指肠异物（1/21）。术前高胆红素血症和拔管后低血压（平均动脉压<60 mmHg）与短期和长期生存率降低在统计学上相关。26只猫中有17只记录了短期生存，13只记录了长期生存。中位生存时间（MST）为86天（范围，0 - 1497天）。发现恶性肿瘤猫的MST为17天（范围，2 - 520天），而炎症性复合物导致的EHBO猫的MST为1165天（范围，61 - 2268天）。术前高胆红素血症和术后即刻低血压可能是接受EHBO手术猫的预后因素。EHBO由炎症引起的猫比肿瘤性病因的猫预后更有利。需要进一步研究来评估所观察到的关联的有效性。
