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. 2022 Apr 21;18(1):146.
doi: 10.1186/s12917-022-03241-4.

Diagnostic value of endoscopic retrograde cholangiopancreatography and therapeutic value of endoscopic sphincterotomy in dogs with suspected hepatobiliary disorders

Vahideh Rahmani  1 , Thomas Spillmann  2 , Jorma Halttunen  3 , Pernilla Syrjä  4 , Mirja Ruohoniemi  2
Affiliations

Diagnostic value of endoscopic retrograde cholangiopancreatography and therapeutic value of endoscopic sphincterotomy in dogs with suspected hepatobiliary disorders

Vahideh Rahmani et al. BMC Vet Res. .

Abstract

Background: Conventional diagnostic methods have some limitations in diagnosing specific causes of canine hepatobiliary disorders. In the evaluation of the hepatobiliary system in dogs, ultrasonography (US) is the first imaging method of choice. Nonetheless, endoscopic retrograde cholangiopancreatography (ERCP) has also been proven to be a practicable technique for evaluating canine hepatobiliary (endoscopic retrograde cholangiography, ERC) and pancreatic duct (endoscopic retrograde pancreatography, ERP) disorders, providing additional therapeutic options by sphincterotomy (EST). To date, the efficacy and safety of diagnostic and therapeutic ERCP has not been evaluated in veterinary medicine literature. The present study sought to report complications and outcomes of dogs undergoing ERCP and EST, and to assess the usefulness of diagnostic ERCP by comparing the findings of US, ERCP and histopathological findings in liver and pancreas.

Results: This retrospective case series comprises data collected from 15 dogs that underwent successful ERC/ERCP. Nine dogs underwent EST following ERC. US and ERC were best in agreement when assessing the common bile duct. In case of disagreement between the modalities, the ERC findings of the ductal structures were in line with the available pathology findings more often than the US findings, whereas the opposite was noted for the gallbladder. The technical success rates were 88.2% for ERC, 66.7% for ERP, and 81.8% for EST, with no major complications during or immediately after the procedure. Immediate bile flow after EST was recorded in 7/9 dogs but only four showed coinciding clinical and laboratory improvement and four dogs were euthanized within 1-6 days after EST.

Conclusions: US remains a valuable initial diagnostic imaging method for hepatobiliary disorders and allows good assessment of the gallbladder. ERC can serve as a complementary procedure for diagnostic assessment of the hepatobiliary duct disorders. However, in order to improve the outcomes of EST, careful selection of patients for the procedure would require more advanced diagnostic imaging of the hepatobiliary area.

Keywords: ERCP; EST; Endoscopic retrograde cholangiopancreatography; Endoscopic sphincterotomy; Fluoroscopy; Gastroduodenoscopy; Hepatobiliary disorders.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Images of a non-icteric 11-year-old male Short-haired Collie (Dog 13). a Ultrasonographic image acquired before ERC, showing dilatation of the common bile duct (cursors). b Fluoroscopic image acquired during ERC, representing dilatation of the common bile duct (arrow, maximum diameter 10 mm) and the gallbladder filled with the contrast material
Fig. 2
Fig. 2
Images of an icteric 9-year-old female Red Irish Setter (Dog 2). a Endoscopic image of the prominent major papilla. b Fluoroscopic image acquired during ERC showing marked dilatation of the extrahepatic ducts (arrow) without contrast filling of the common bile duct. c Thickened duodenal wall due to Infiltrative carcinoma (arrows) around the common bile duct (arrowhead) at autopsy 1 day after ERC and EST
Fig. 3
Fig. 3
Images of an icteric 7-year-old female Giant Poodle (Dog 3). a Endoscopic image of the major papilla before EST. b Endoscopic image while the sphincterotomy catheter is entering the major papilla. c Fluoroscopic image acquired during ERC, showing radiolucent concretions (arrow) at the beginning of the common bile duct. d Fluoroscopic image showing dilatation of the common bile duct (arrow, maximum diameter 5 mm). e Fluoroscopic image representing marked dilatation of the intrahepatic duct. f Endoscopic image of the major papilla 3 weeks after EST
Fig. 4
Fig. 4
Fluoroscopic image of a non-icteric 2-year-old male Belgian shepherd dog (Dog 10) acquired during ERC representing abnormal course of the CBD (arrow) in a half circle around the duodenum and not straight to the gallbladder
Fig. 5
Fig. 5
Serum bilirubin concentrations and serum activities of alkaline phosphatase (ALP) and alanine aminiotransferase (ALT) of four dogs before and after successful EST
See this image and copyright information in PMC

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