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Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both.
Parkanzky, Max; Grimes, Janet; Schmiedt, Chad; Secrest, Scott; Bugbee, Andrew.
Afiliación
  • Parkanzky M; Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia.
  • Grimes J; Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia.
  • Schmiedt C; Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia.
  • Secrest S; Department of Veterinary Biosciences and Diagnostic Imaging, University of Georgia College of Veterinary Medicine, Athens, Georgia.
  • Bugbee A; Department of Small Animal Medicine and Surgery, University of Georgia College of Veterinary Medicine, Athens, Georgia.
J Vet Intern Med ; 33(5): 2057-2066, 2019 Sep.
Article en En | MEDLINE | ID: mdl-31490022
BACKGROUND: Gallbladder mucoceles (GBM) typically are treated by cholecystectomy. Medical management rarely has been reported and medical and surgical management have not been compared. HYPOTHESIS/OBJECTIVES: To compare survival of dogs treated for GBM by medical management or cholecystectomy or both. ANIMALS: Eighty-nine client-owned dogs diagnosed with GBM that received cholecystectomy or medical treatment or both from 2011 to 2017. METHODS: Potential cases were identified by searching the medical records database. Data collected included signalment, clinicopathologic results, treatments, and ultrasonographic images and reports. Dogs were grouped according to the treatment received (medical management, surgical treatment, or both) that was chosen at the discretion of the attending veterinarian. Survival analysis was performed and prognostic variables identified and compared between treatment groups. RESULTS: Of dogs surviving at least 14 days after diagnosis, median survival times were 1802 (95% confidence interval [CI], 855-not reached) days, 1340 (95% CI, 444-1340) days, and 203 (95% CI, 18-525) days, for the surgical, medical, and medical then surgical treatment groups, respectively, and differed significantly (P < .0001). Gallbladder mucocele type (P = .05), serum alkaline phosphatase activity (P = .0001), and serum creatinine (P = .002) and phosphorus (P = .04) concentrations were associated with decreased survival across groups. Suspicion of biliary rupture on abdominal ultrasound (AUS) examination was correlated with increased survival in the surgical group (P = .02). CONCLUSIONS AND CLINICAL IMPORTANCE: Cholecystectomy for the treatment of GBM results in the best long-term survival in dogs surviving the immediate postoperative period (14 days) compared to medical management. Although medical management is associated with shorter survival compared to surgical treatment, it is a reasonable alternative when surgery cannot be pursued.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistectomía / Enfermedades de los Perros / Enfermedades de la Vesícula Biliar / Mucocele Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Animals Idioma: En Revista: J Vet Intern Med Asunto de la revista: MEDICINA INTERNA / MEDICINA VETERINARIA Año: 2019 Tipo del documento: Article País de afiliación: Georgia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Colecistectomía / Enfermedades de los Perros / Enfermedades de la Vesícula Biliar / Mucocele Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Animals Idioma: En Revista: J Vet Intern Med Asunto de la revista: MEDICINA INTERNA / MEDICINA VETERINARIA Año: 2019 Tipo del documento: Article País de afiliación: Georgia Pais de publicación: Estados Unidos