In a healthy cat, bile made in the liver flows through the gallbladder, to the common bile duct, and into the intestines. When the common bile duct becomes constricted, blocked or swollen shut, sometimes an emergency surgical procedure called a “Cholecystoduodenostomy” may be recommended. In this procedure, a hole is created in both the gallbladder and the intestine and the two organs are attached so that bile can bypass the common bile duct altogether. This procedure must be performed by an ACVS board-certified veterinary surgeon.
The surgery is very risky, in part due to the fact that most cats needing it have already presented with severe anorexia and vomiting. In some, the first indication that something is wrong with the bile duct is an elevated level of bilirubin on a blood test. An ultrasound may also reveal a thickened gallbladder or a visual blockage. If the gallbladder is deemed healthy, establishing a new permanent duct may be the best course of action.