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Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both

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 bot...

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Autores principales: Parkanzky, Max, Grimes, Janet, Schmiedt, Chad, Secrest, Scott, Bugbee, Andrew
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766501/
https://www.ncbi.nlm.nih.gov/pubmed/31490022
http://dx.doi.org/10.1111/jvim.15611
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author Parkanzky, Max
Grimes, Janet
Schmiedt, Chad
Secrest, Scott
Bugbee, Andrew
author_facet Parkanzky, Max
Grimes, Janet
Schmiedt, Chad
Secrest, Scott
Bugbee, Andrew
author_sort Parkanzky, Max
collection PubMed
description 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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spelling pubmed-67665012019-09-30 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 J Vet Intern Med SMALL ANIMAL 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. John Wiley & Sons, Inc. 2019-09-06 2019 /pmc/articles/PMC6766501/ /pubmed/31490022 http://dx.doi.org/10.1111/jvim.15611 Text en © 2019 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle SMALL ANIMAL
Parkanzky, Max
Grimes, Janet
Schmiedt, Chad
Secrest, Scott
Bugbee, Andrew
Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
title Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
title_full Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
title_fullStr Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
title_full_unstemmed Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
title_short Long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
title_sort long‐term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both
topic SMALL ANIMAL
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766501/
https://www.ncbi.nlm.nih.gov/pubmed/31490022
http://dx.doi.org/10.1111/jvim.15611
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