What is Surgical Removal of Gallbladder Obstruction?
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.
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Surgical Removal of Gallbladder Obstruction Procedure in Dogs
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.
Efficacy of Surgical Removal of Gallbladder Obstruction in Dogs
A laparoscopic cholecystectomy procedure is the most effective form of long-term treatment against canine gallbladder obstructions.
Surgical Removal of Gallbladder Obstruction Recovery in Dogs
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.
Cost of Surgical Removal of Gallbladder Obstruction in Dogs
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.
Dog Surgical Removal of Gallbladder Obstruction Considerations
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.
Surgical Removal of Gallbladder Obstruction Prevention in Dogs
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.
Surgical Removal of Gallbladder Obstruction Questions and Advice from Veterinary Professionals
My 14 year old cairn terrier had her gall bladder removed. It was determined due to the high levels of enzymes, etc. with the liver. After an ultra sound it was proven to be her gall bladder. After it was surgically removed, she came home in 2 days with her entire tummy stitched up. After 10 days she was due to have the stitches removed however she never really gained her appetite back so when I took her in for the stitches to be removed we discussed her health issues. They decided that another ultra sound was needed. They found another obstruction that needed to be flushed out which meant another surgery. I was assured that once they flushed out the area it should/would be better. Unfortunately, they claimed they were unable to flush the obstruction through and had to use stents to hold open the passage. And they could not identify the obstruction and left it inside her. Needless to say, having had 2 major surgeries in 10 days, my little nugget didn't survive. My question is why didn't they flush her system once the gall bladder was removed and before they closed her back up the first surgery? Shouldn't they have seen this obstruction? I feel that her chances to survive a major surgery within 10 days was risky but was assured it would be ok. I'm heartbroken and second guessing the expertise of the first surgeon not noticing the obstruction while performing the first surgery. Could a new obstruction have occurred within the 10 days and if so, why couldn't it be identified and flushed out?
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Our 12 year old neutered male Cocker Spaniel is being considered for gallbladder removal due to gallbladder mucocele. What is the mortality rate for this type of operation for this dog and his age?
According to the Canadian Veterinary Journal (see link below to an article about cholecystectomy in a 12 year old Cocker Spaniel), the perioperative mortality rate for this surgery is between 21% to 32% but risk factors for this surgery are increased liver enzymes prior to surgery which would be checked by your Veterinarian before hand; however cholecystectomy is the treatment of choice for gallbladder mucocele. There are little resources on medical management with mixed reports of success which are also discussed in the article linked below. Regards Dr Callum Turner DVM
My nine-year-old beagle just went for emergency gallbladder surgery tonight the doctor never discuss the cost she had elevated liver enzyme’s over three times the normal amount and they had to tap her stomach with fluid prior to surgery very concerned
My 9 year old cattle dog/Shar Pei mutt was diagnosed with gall bladder "sludging." Based on sonogram our vet recommended having the gall bladder removed now as the situation could worsen and the risks of surgery could increase as the dog gets older and/or the problem affects the liver. The cost is high but not an issue.
What I am worried about in reading your response is what seems like a very high mortality rate for the surgery. She's not showing any outward signs of discomfort other than a noisy stomach through the night once a week.
Is the risk worth taking or how should I be evaluating this?
Were you ever given a response to this? My mini schnauzer just had his gallbladder removed on Thursday. I understand the risk, but need to know when we will be out of the woods post surgery. Does anyone know?
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