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Introduction
Cholecystoenterostomy surgery is performed infrequently in cases of extra-hepatic biliary obstruction. This multicentric retrospective study aims to provide a current mortality rate and identify prognostic factors for morbidity and mortality.
Materials and Methods
Multicentre retrospective records-based study. Records of dogs and cats that had undergone cholecystoenteric anastomosis surgery at eight referral hospitals were reviewed. Data were collected on signalment, clinical signs, diagnosis, perioperative medications, blood analysis, clotting times, surgical procedure, intra- and post-operative complications, hospitalisation periods, survival to discharge (STD) and recorded post-discharge complications.
Results
62 patients were identified: 23 dogs and 39 cats. Overall STD was 60%: 54% in cats and 70% in dogs. Clinical signs at presentation included hyporexia/anorexia, icterus, vomiting, lethargy, ascites and weight loss. No biochemical or haematological marker was associated with survival to discharge. In-hospital complications were documented in 52% of patients, including cardiac arrest (16%), anaemia (13%), peritonitis (10%), hypoalbumineamia (8%), sepsis (6%) and regurgitation (6%). Hypotension was a frequent intraoperative complication affecting 18/63 (29%) of patients.
Pre-operative antibiotic administration was associated with higher in-hospital complications. Lethargy was associated with STD. Cats with lower body weight were less likely to develop complications following discharge.
Discussion/Conclusions
The prognosis for patients undergoing cholecystoenterostomy surgery is guarded, with high rates of in-hospital complications. Mortality in cats was higher than in dogs.
34th Annual Scientific Meeting proceedings
Stream: SA
|
Session: Small Animal Resident Forum - Soft Tissue
Date/Time: 06-07-2023 (18:45 - 19:00) | Location: Chamber Hall
Date/Time: 06-07-2023 (18:45 - 19:00) | Location: Chamber Hall
Outcome and Complications Associated with Cholecystoenterostomy Surgery in Dogs and Cats
Prior SF1, Anderson D*2, Frykfors von Hekkel A*3, Vincenti S*4, Compagnone K*5, Forster K*6, Burton C*6, Wavreille V*7, Murgia D*8
1The Queens Veterinary School Hospital, University of Cambridge, Cambridge, United Kingdom, 2Anderson Moores, Winchester, United Kingdom, 3Royal Veterinary College, London, United Kingdom, 4Vetsuisse Faculty, Universität Bern, Bern, Switzerland, 5Northwest Veterinary Specialists, Runcorn, United Kingdom, 6Davies Veterinary Specialists, Hitchin, United Kingdom, 7Department of Veterinary Clinical Sciences, The Ohio State University, Ohio, USA, 8Dick White Referrals, Newmarket, United Kingdom.
Introduction
Cholecystoenterostomy surgery is performed infrequently in cases of extra-hepatic biliary obstruction. This multicentric retrospective study aims to provide a current mortality rate and identify prognostic factors for morbidity and mortality.
Materials and Methods
Multicentre retrospective records-based study. Records of dogs and cats that had undergone cholecystoenteric anastomosis surgery at eight referral hospitals were reviewed. Data were collected on signalment, clinical signs, diagnosis, perioperative medications, blood analysis, clotting times, surgical procedure, intra- and post-operative complications, hospitalisation periods, survival to discharge (STD) and recorded post-discharge complications.
Results
62 patients were identified: 23 dogs and 39 cats. Overall STD was 60%: 54% in cats and 70% in dogs. Clinical signs at presentation included hyporexia/anorexia, icterus, vomiting, lethargy, ascites and weight loss. No biochemical or haematological marker was associated with survival to discharge. In-hospital complications were documented in 52% of patients, including cardiac arrest (16%), anaemia (13%), peritonitis (10%), hypoalbumineamia (8%), sepsis (6%) and regurgitation (6%). Hypotension was a frequent intraoperative complication affecting 18/63 (29%) of patients.
Pre-operative antibiotic administration was associated with higher in-hospital complications. Lethargy was associated with STD. Cats with lower body weight were less likely to develop complications following discharge.
Discussion/Conclusions
The prognosis for patients undergoing cholecystoenterostomy surgery is guarded, with high rates of in-hospital complications. Mortality in cats was higher than in dogs.
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