33rd Annual Scientific Meeting proceedings

Introduction: Extrahepatic biliary obstruction (EHBO) is uncommonly encountered in cats. Surgical treatment aims to decompress the biliary tract and ensure bile duct patency. Traditionally, derivation of the bile flow by cholecystoenterostomy (CEE) is performed in cats, with various complications and low survival rates (around 42.9%) reported. In veterinary medicine, cholecystotomy is not widely used in practice. The objective was to describe the association of cholecystotomy, retrograde hydropulsion of choleliths and choledochal stenting (CS) as a unique technique to treat EHBO.

Case description: Three adult domestic shorthair cats were presented with anorexia, lethargy, vomiting. Blood analysis revealed hyperbilirubinemia and increased liver enzymes. Abdominal ultrasonography showed evidence of EHBO. A cholecystotomy was performed and choleliths were removed from the gallbladder, the cystic duct and common bile duct (CBD) by retrograde hydropulsion with sterile saline. A CS was placed in the CBD, across the duodenal papilla.

Results: All cats required nasogastric feeding for 48 hours. For 2 cases, blood transfusion was performed 24 hours postoperatively.  Cases were all discharged within 4 days following surgery. CS passage was suspected at 11, 14 and 17 days postoperatively. Two cases were still alive 12 and 14 months postoperatively with no major complication related to the surgery encountered in the short and medium-term follow-up. The last cat was euthanized 41 days postoperatively due to recurrence of EHBO.

Discussion/Conclusion: This procedure is affordable and can be performed successfully. It can be considered as a reliable treatment option for EHBO in cats. Major complications encountered include recurrence of EHBO.