Extrahepatic bile duct obstruction (EHBDO) is usually tentatively diagnosed based on the clinical findings. However, definitely diagnosing obstructed common bile duct (CBD) is challenging without certain diagnostics. The goal of this study is to evaluate the feasibility of ultrasound-guided percutaneous cholangiography (UPC) to determine if CBD is truly obstructed and to re-evaluate the term, EHBDO, used in clinical application.
Four dogs and two cats, tentatively diagnosed with “infected EHBDO”, were enrolled in this study. UPC was performed, (1) cholecystocentesis, removing most of the bile to decompress the gallbladder and for cytology and culture/sensitivity; (2) less than 5 mL of Iodixanol 320 was injected into the gallbladder. Ventrodorsal, left oblique ventrodorsal, left lateral and right lateral projections of the abdomen were made 2 minutes after UPC, every 10 minutes for the first hour and every 30 minutes after until contrast medium was noted in the duodenum.
All patients had CBD dilation (4.2 - 14.4 mm in diameter). The contrast was noted in the duodenum in five patients. Only one dog was diagnosed with completely obstructed CBD given no contrast in the duodenum 4 hours after UPC. The rest was diagnosed with CBD dilation and gallbladder delayed emptying. The time for UPC was from 2 to 240 minutes.
UPC is a feasible technique in patients with dilated CBD and can be used to confirm complete obstruction of CBD. Based on this study, the term “extrahepatic bile duct disease” should be used instead of EHBDO before further diagnostics, such as UPC.
Owner, Medical director
Fleur Animal Hospital
Dr. Chung-In Wang is an enthusiastic veterinarian who obtained his DVM degree in Taiwan and has strong interests in gallbladder disease. After graduation, he obtained the certificate in advanced small animal medicine and surgery training in Taiwan in 2000. Then,he worked at the Fleur Animal Hospital as an owner and veterinarian since 2004. He was invited as a speaker in 2015 FASAVA. A novel technique of ultrasound-guided percutaneous cholangiography in dogs was selected for oral presentation in 2016 ACVR meeting. In his spare time, he likes to cook for his family.
Friday, June 15
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