Evaluation of cellophane banding with and without intraoperative attenuation for treatment of congenital extrahepatic portosystemic shunts in dogs.
OBJECTIVE
To evaluate the effect of intraoperative attenuation of congenital extrahepatic portosystemic shunts (CEPSSs) during cellophane banding procedures in dogs.


METHODS
Retrospective case series and prospective study.


METHODS
18 cases evaluated retrospectively and 14 dogs evaluated prospectively.


METHODS
Gradual occlusion of CEPSSs was performed via cellophane banding. Shunts were occluded to a diameter < 3.0 mm during surgery in dogs prospectively enrolled in the partial attenuation group, whereas the shunt was not attenuated during surgery in dogs prospectively enrolled in the no-attenuation group or in dogs that had previously undergone surgery and were retrospectively evaluated. Postprandial serum bile acids (PPSBA) concentrations were measured before surgery and at various time points after surgery.


RESULTS
Mean +/- SD PPSBA concentrations were 26.8 +/- 24.5 micromol/L at < 2.25 months after surgery (n = 16 dogs), 22.1 +/- 14.0 micromol/L from 2.25 to 6 months after surgery (12 dogs), and 34.9 +/- 32.5 micromol/L at > 6 months after surgery (22 dogs). In the prospectively enrolled dogs, mean PPSBA concentrations increased over time in dogs in the partial attenuation group, but not in dogs in the no-attenuation group.


CONCLUSIONS
Cellophane banding may be used to occlude larger CEPSSs and may decrease the need for intraoperative monitoring of portal vein blood pressure. The technique may facilitate minimally invasive treatment of CEPSSs in dogs. Intraoperative attenuation of CEPSSs to a diameter < 3.0 mm is not necessary and may result in a less favorable outcome.
Frankel
Daniel
D
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Ft Collins, CO 80525, USA.
Seim
Howard
H
MacPhail
Catriona
C
Monnet
Eric
E
D000818:Animals; D001647:Bile Acids and Salts / Q000032:analysis*; D002476:Cellophane; D003250:Constriction; D004283:Dog Diseases / Q000151:congenital / Q000601:surgery*; D004285:Dogs; D005260:Female; D006975:Hypertension, Portal / Q000151:congenital / Q000601:surgery / Q000662:veterinary*; D007430:Intraoperative Care / Q000379:methods / Q000662:veterinary; D008297:Male; D011168:Portal System / Q000002:abnormalities / Q000601:surgery; D011169:Portal Vein / Q000002:abnormalities / Q000601:surgery; D019518:Postprandial Period; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
D001647:Bile Acids and Salts; D002476:Cellophane