Display options
Cite
Griffin MA, Culp WTN, Giuffrida MA, et al. Choledochal stenting for treatment of extrahepatic biliary obstruction in cats. J Vet Intern Med. 2021;doi: 10.1111/jvim.16176.
Griffin, M. A., Culp, W. T. N., Giuffrida, M. A., Selmic, L. E., Denitz, J. C., Perry, J. A., Schoelkopf, A. C., Milovancev, M., Phillips, H., Wallace, M. L., Steffey, M. A., Balsa, I. M., & Mayhew, P. D. (2021). Choledochal stenting for treatment of extrahepatic biliary obstruction in cats. Journal of veterinary internal medicine, . https://doi.org/10.1111/jvim.16176
Griffin, Maureen A, et al. "Choledochal stenting for treatment of extrahepatic biliary obstruction in cats." Journal of veterinary internal medicine vol. (2021). doi: https://doi.org/10.1111/jvim.16176
Griffin MA, Culp WTN, Giuffrida MA, Selmic LE, Denitz JC, Perry JA, Schoelkopf AC, Milovancev M, Phillips H, Wallace ML, Steffey MA, Balsa IM, Mayhew PD. Choledochal stenting for treatment of extrahepatic biliary obstruction in cats. J Vet Intern Med. 2021 Sep 29; doi: 10.1111/jvim.16176. Epub 2021 Sep 29. PMID: 34586683.
Copy Download .nbib Format: NLM
Share it on

J Vet Intern Med. 2021 Sep 29; doi: 10.1111/jvim.16176. Epub 2021 Sep 29.

Choledochal stenting for treatment of extrahepatic biliary obstruction in cats.

Journal of veterinary internal medicine

Maureen A Griffin, William T N Culp, Michelle A Giuffrida, Laura E Selmic, Jordan C Denitz, James A Perry, Alexander C Schoelkopf, Milan Milovancev, Heidi Phillips, Mandy L Wallace, Michele A Steffey, Ingrid M Balsa, Philipp D Mayhew

Affiliations

  1. University of California-Davis, School of Veterinary Medicine, Davis, California, USA.
  2. Ohio State University, College of Veterinary Medicine, Columbus, Ohio, USA.
  3. Veterinary Cancer & Surgery Specialists, Milwaukie, Oregon, USA.
  4. Oregon State University, Carlson College of Veterinary Medicine, Corvallis, Oregon, USA.
  5. University of Illinois, College of Veterinary Medicine, Champaign, Illinois, USA.
  6. University of Georgia, College of Veterinary Medicine, Athens, Georgia, USA.

PMID: 34586683 DOI: 10.1111/jvim.16176

Abstract

BACKGROUND: Limited information currently exists regarding the clinical progression and outcomes of cats that undergo choledochal stenting as a treatment for extrahepatic biliary obstruction (EHBO).

HYPOTHESIS/OBJECTIVES: Describe clinical characteristics, indications for choledochal stent placement, procedure, and outcomes in a cohort of cats undergoing choledochal stenting and evaluate risk factors associated with survival as well as recurrence of EHBO in affected cats.

ANIMALS: Twenty-three client-owned cats undergoing choledochal stent placement.

METHODS: Retrospective study. Medical records from 6 academic institutions were reviewed, and data were extracted and analyzed statistically.

RESULTS: Median age of cats was 10.1 years (range, 2-16), and all cats had at least 2 clinical signs. Most common clinical signs were vomiting in 20/22 (90.9%), inappetence in 19/22 (86.4%), and lethargy in 19/23 (82.6%). Procedural complications were uncommon and rarely related to the stenting procedure. Clinical signs improved postoperatively in 15/20 (75.0%) cats and serum total bilirubin concentration decreased postoperatively in 13/19 (68.4%) cats. Eighteen (78.3%) cats survived to discharge. Recurrence of EHBO was documented in 7/18 (38.9%) cats that survived to discharge. Cholelithiasis was associated with recurrence of EHBO. Median survival time for cats that survived to discharge was 931 days (range, 19-3034). Absence of peritoneal effusion was associated with survival to discharge.

CONCLUSIONS AND CLINICAL IMPORTANCE: Choledochal stenting was an effective treatment modality in cats with EHBO with few procedural complications and potential for prolonged survival, but substantial risk for recurrence of EHBO was identified.

© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.

Keywords: bilirubin; common bile duct; gallbladder; icterus; stent

References

  1. Otte CM, Penning LC, Rothuizen J. Feline biliary tree and gallbladder disease: aetiology, diagnosis and treatment. J Feline Med Surg. 2017;19:514-528. - PubMed
  2. Monnet E. Biliary stenting. Gastrointestinal Surgical Techniques in Small Animals. Hoboken, NJ: John Wiley & Sons, Inc; 2020:293-296. - PubMed
  3. Mayhew P, Weisse C. Treatment of pancreatitis-associated extrahepatic biliary tract obstruction by choledochal stenting in seven cats. J Small Anim Pract. 2008;49:133-138. - PubMed
  4. Furneaux RW. A series of six cases of sphincter of Oddi pathology in the cat (2008-2009). J Feline Med Surg. 2010;12:794-801. - PubMed
  5. Grand JG, Doucet M, Albaric O, Bureau S. Cyst of the common bile duct in a cat. Aust Vet J. 2010;88:268-271. - PubMed
  6. Leveille R, Biller DS, Shiroma JT. Sonographic evaluation of the common bile duct in cats. J Vet Intern Med. 1996;10:296-299. - PubMed
  7. Gaillot HA, Penninck DG, Webster CR, et al. Ultrasonographic features of extrahepatic biliary obstruction in 30 cats. Vet Radiol Ultrasound. 2007;48:439-447. - PubMed
  8. Alon U, Berant M, Mordechovitz D, Hashmonai M, Better OS. Effect of isolated cholaemia on systemic haemodynamics and kidney function in conscious dogs. Clin Sci. 1982;63:59-64. - PubMed
  9. Green J, Beyar R, Sideman S, Mordechovitz D, Better OS. The “jaundiced heart”: a possible explanation for postoperative shock in obstructive jaundice. Surgery. 1986;100:14-20. - PubMed
  10. Dixon J, Armstrong C, Duffy S, et al. Factors affecting morbidity and mortality after surgery for obstructive jaundice: a review of 373 patients. Gut. 1983;24:845-852. - PubMed
  11. Mayhew PD, Savigny MR, Otto CM, et al. Evaluation of coagulation in dogs with partial or complete extrahepatic biliary tract obstruction by means of thromboelastography. J Am Vet Med Assoc. 2013;242:778-785. - PubMed
  12. Dixon J, Armstrong C, Duffy S, et al. Upper gastrointestinal bleeding. A significant complication after surgery for relief of obstructive jaundice. Ann Surg. 1984;199:271. - PubMed
  13. Bayer I, Ellis H. Jaundice and wound healing: an experimental study. Br J Surg. 1976;63:392-396. - PubMed
  14. Mayhew PD, Weisse C. Livery and biliary system. In: Johnston SA, Tobias KM, eds. Veterinary Surgery: Small Animal. 2nd ed. St. Louis, MO: Elsevier; 2018. - PubMed
  15. Buote NJ, Mitchell SL, Penninck D, Freeman LM, Webster CRL. Cholecystoenterostomy for treatment of extrahepatic biliary tract obstruction in cats: 22 cases (1994-2003). J Am Vet Med Assoc. 2006;228:1376-1382. - PubMed
  16. Mayhew P, Holt D, McLear R, et al. Pathogenesis and outcome of extrahepatic biliary obstruction in cats. J Small Anim Pract. 2002;43:247-253. - PubMed
  17. Bailey ME. Endotoxin, bile salts and renal function in obstructive jaundice. Br J Surg. 1976;63:774-778. - PubMed
  18. Son TT, Thompson L, Serrano S, Seshadri R. Retrospective study: surgical intervention in the management of severe acute pancreatitis in cats: 8 cases (2003-2007). J Vet Emerg Crit Care. 2010;20:426-435. - PubMed
  19. Chu C. Classification and general characteristics of suture materials. Wound Closure Biomaterials and Devices. Vol 49. Boca Raton, FL: CRC Press; 1997. - PubMed
  20. Berent AC, Weisse CW, Todd K, Bagley DH. Technical and clinical outcomes of ureteral stenting in cats with benign ureteral obstruction: 69 cases (2006-2010). J Am Vet Med Assoc. 2014;244:559-576. - PubMed
  21. Eich CS, Ludwig LL. The surgical treatment of cholelithiasis in cats: a study of nine cases. J Am Anim Hosp Assoc. 2002;38:290-296. - PubMed
  22. Sung J, Leung J, Shaffer E, et al. Ascending infection of the biliary tract after surgical sphincterotomy and biliary stenting. J Gastroenterol Hepatol. 1992;7:240-245. - PubMed

Publication Types