Cholecystojejunostomy in Cats

Cholecystojejunostomy in cats is a surgical procedure in which the jejunum is positioned next to the gallbladder to divert the flow of bile. Cholecystojejunostomy is a similar surgical procedure to cholecystoduodenostomy, but does not usually require the gallbladder to be mobilized. A veterinary surgeon can use two techniques to perform a cholecystojejunostomy in cats; loop cholecystojejunostomy or Roux-en-Y loop. The goal of using ether technique is to discontinue the use of the deficient bile duct by bringing a segment of the jejunum to the gallbladder for side-by-side anastomosis.  

The veterinarian will create an opening in the two organs and permanently conjoin them, allowing bile to flow directly into the intestine. Bile is the fluid the body uses to break down fats that the feline consumes during a meal. Usually, bile flows down from the liver, into the gallbladder and into the small intestine through a bile duct. However, an obstruction of the bile duct will prevent bile from reaching the small intestine. A veterinary surgeon may perform a cholecystojejunostomy in a cat if he/she has a tumor, trauma, or other condition affecting the flow of bile. 

Prior to surgery, all obstructions are confirmed and biopsies are performed. A veterinary surgeon can use two techniques to perform a cholecystojejunostomy in cats; loop cholecystojejunostomy or Roux-en-Y loop.

Loop Cholecystojejunostomy

1. A proximal section of the jejunum will be brought adjacent to the gallbladder.
2. Two incisions, about 3 cm in length, will be made parallel to each other on the aspects of the jejunum and the gallbladder. 
3. 4/0 synthetic, absorbable suture is used to close the cranial dorsal incision line on the lumen. 
4. The same suture material will be used to close the caudal ventral incision, which will bring the two openings onto one another and allow direct infusion of bile. 
5. Both ends of the suture pattern will be securely knotted to prevent leakage of digestive fluids into the abdominal space. 

Roux-en-Y loop Cholecystojejunostomy

1. A proximal section of the jejunum will be brought adjacent to the gallbladder. 
2. The jejunum is transected and sutured closed.
3. Just caudal to the duodenum, the jejunum is anastomosed to the gallbladder.