Surgical Removal of Gallbladder Obstruction in Dogs

The gallbladder is a pear-shaped organ that sits beneath the liver, on its right side. The gallbladder’s main function is to collect and concentrate bile, a digestive fluid produced by the liver. This digestive fluid travels through tubular channels where it reaches the small intestine after a canine consumes a meal. A gallbladder obstruction commonly occurs in these ducts from the salt component of bile. 

A veterinarian can remove a gallbladder obstruction in a number of ways, but the most effective treatment of gallstones is the complete removal of the gallbladder organ. Surgical removal of the gallbladder is termed, laparoscopic cholecystectomy. A laparoscopic cholecystectomy can be performed by a licensed veterinarian with appropriate surgical equipment. 

The dog will need to be fasting (no food or water) the night before surgery and the day of surgery. Prior to anesthesia, the dog’s blood will be tested to ensure his/her organs are functioning properly and undiagnosed diseases are absent from the blood work. A pre-anesthetic, pain medication and antibiotic are injection to the dog prior to being taken to the operating room. 

Port & Instrument Placement 

• The dog is placed in dorsal recumbency on the surgical table with legs tied away from the midline for stabilization purposes. 
• The abdomen is shaved and prepared with chlorhexidine in regions lateral to the superior iliac spine. 
• The operative field is draped. 
• A 1 ½ cm longitudinal incision is made at the inferior aspect of the umbilicus, through the rectus sheath’s subcutaneous fat. 
• A Kocher clamp grasps the reflection of linea alba onto the umbilicus in an elevating fashion. 
• A No. 15 blade is them used to make an incision into the linea alba, 1.2 cm in length. 
• Using 0 polyglactin suture, two U stitches are placed on both sides of the fascial incision using a curved needle. 
• The peritoneum is elevated between two clamps and an 11 mm blunt Hasson trocar is inserted into the abdominal cavity. The abdominal cavity is then inflated using carbon dioxide to allow visualization space. 
• A laparoscope is advanced into the abdominal cavity. 

Exposure & Dissection 

• Adhesions and fundus cephalad are retracted using a lateral grasper. 
• A medial grasper is applied to the infundibulum for retractions in the caudolateral direction. 
• An L-hook electrocautery is used to lyse the duodenum and omentum for better view of the gallbladder. 
• The cystic duct and artery are dissected in the triangle of Calot to obtain critical view. Once critical view is obtained, structures can be separated from the gallbladder.
• The gallbladder and liver are separated. Use of traction and hook tools to remove gallbladder from the gallbladder bed. Electrocautery is used in removal. 
• Bleeding is controlled. 

Removing the Gallbladder 

• Two 5 mm graspers are used to hold the gallbladder up. 
• The gallbladder is placed into an endoscopic retrieval pouch. 
• Surgical tools are removed. 
• The gallbladder bed and suprahepatic spaces are irrigated, followed by the suction of fluids. Bile fluids are also removed. 
• All instruments used to view the abdominal cavity are removed under direct vision. 
• All skin incisions are closed with 4-0 absorbable monofilament suture. 

A laparoscopic cholecystectomy procedure is the most effective form of long-term treatment against canine gallbladder obstructions.

The canine will be hospitalized following surgery in order to recover under constant, professional motorization. When the veterinarian allows the patient to return home, the dog must be confined and restricted of physical activity to prevent the sutures from coming loose. An Elizabethan collar may be sent home with the dog to prevent manipulation of the incision site. Pain medications, paired with a broad spectrum antibiotic will be administered as directed by the veterinarian. 

The cost to have a gallbladder obstruction removed depends on the specific case and the type of surgical procedure performed. However, dog owners could estimate the cost of gallbladder removal surgery to be about $3,000-$6,000. Discuss price with your local veterinary provider to obtain a more accurate estimated cost.

As with all major abdominal surgeries, complications may occur. Although rare, a dog that has undergone a laparoscopic cholecystectomy procedure may develop surgery-induced bleeding, infection, organ or tissue injury. 

A low fat, balanced diet may aid in the prevention of a gallbladder obstruction, as a high level of fat could raise the cholesterol levels in the bile. Also, gallbladder stones form when there is a high level of salts and cholesterol in the secreted bile, so it makes sense that a diet change could be an easy prevention method for a canine gallbladder obstruction.