American journal of veterinary research · 2025
Laparoscopic-assisted fluoroscopic cholangiography is a feasible technique for visualizing the biliary system in canine cadavers.
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Azuma Kazushi, Ohlendorf Alex, Shropshire Sarah, Monnet Eric
Аннотация
OBJECTIVE: To assess the feasibility of laparoscopic-assisted fluoroscopic cholangiography for visualizing the biliary system in canine cadavers.
METHODS: 10 canine cadavers were used. Two 5-mm laparoscopic ports were placed via ventral midline incisions. An 8.5-French pigtail catheter was introduced percutaneously into the gallbladder lumen under laparoscopic guidance. Iohexol contrast medium, diluted in 3 different ratios, was injected, and fluoroscopic images were obtained using a C-arm fluoroscopy unit. Catheters were removed, and gallbladder walls were closed with intracorporeal suturing. Visibility of the cystic duct, hepatic ducts, and common bile duct was graded from excellent to not visible.
RESULTS: Catheter placement was successful in all cadavers. Contrast leakage occurred in 4 cadavers. The common bile duct was graded excellent to good in 7 cadavers and not visible in 1, the cystic duct was excellent to good in 8, and the hepatic ducts were excellent to good in 6 and not visible in 2. The 1:2 iohexol dilution provided optimal visualization in this study. Catheter sites were successfully closed with intracorporeal suturing without observed bile leakage.
CONCLUSIONS: Laparoscopic-assisted fluoroscopic cholangiography is a feasible technique for biliary visualization in canine cadavers, particularly with a 1:2 iohexol dilution.
CLINICAL RELEVANCE: This technique may provide a minimally invasive method for intraoperative biliary assessment in dogs, facilitating identification of anatomy and guidance of surgical procedures. Further studies in live patients are warranted to evaluate safety, effectiveness, and applicability in clinical cases.
METHODS: 10 canine cadavers were used. Two 5-mm laparoscopic ports were placed via ventral midline incisions. An 8.5-French pigtail catheter was introduced percutaneously into the gallbladder lumen under laparoscopic guidance. Iohexol contrast medium, diluted in 3 different ratios, was injected, and fluoroscopic images were obtained using a C-arm fluoroscopy unit. Catheters were removed, and gallbladder walls were closed with intracorporeal suturing. Visibility of the cystic duct, hepatic ducts, and common bile duct was graded from excellent to not visible.
RESULTS: Catheter placement was successful in all cadavers. Contrast leakage occurred in 4 cadavers. The common bile duct was graded excellent to good in 7 cadavers and not visible in 1, the cystic duct was excellent to good in 8, and the hepatic ducts were excellent to good in 6 and not visible in 2. The 1:2 iohexol dilution provided optimal visualization in this study. Catheter sites were successfully closed with intracorporeal suturing without observed bile leakage.
CONCLUSIONS: Laparoscopic-assisted fluoroscopic cholangiography is a feasible technique for biliary visualization in canine cadavers, particularly with a 1:2 iohexol dilution.
CLINICAL RELEVANCE: This technique may provide a minimally invasive method for intraoperative biliary assessment in dogs, facilitating identification of anatomy and guidance of surgical procedures. Further studies in live patients are warranted to evaluate safety, effectiveness, and applicability in clinical cases.