Cholecystoduodenostomy in the Dog Comparison of Two Techniques

Abstract

A mucosal apposition technique for cholecystoduodenostomy was compared to the cutting suture technique. The mucosal apposition technique was easier to perform, less traumatic, and produced a significantly larger anastomotic opening than the cutting suture technique. Eleven of 12 dogs returned to normal activity within 5 days after the mucosal apposition technique. Six of 12 dogs required 10 to 21 days after the cutting suture technique before regaining normal activity. Healing was similar for both techniques. Aerobic and anaerobic bacteria were cultured from the gallbladders of both groups postoperatively.Cholecystograms demonstrated rapid drainage of the biliary system following mucosal apposition. Drainage of the biliary system following the cutting suture technique was slower; gallbladders tended to be irregularly shaped and distended.Gallbladders rapidly filled with contrast material during upper gastrointestinal barium studies following cholecystoduodenostomy by mucosal apposition. Gallbladders filled more slowly and less completely following the cutting suture technique: drainage of refluxed contrast material was delayed in some dogs.Serum enzyme elevations (SGPT, SAP) and subclinical periportal inflammation and fibrosis were found following both techniques. Peripheral circulating eosinophil counts were significantly higher in dogs following the cutting suture technique.