Initial Experience with Endoscopic Retrograde Cholangiography and Biliary Stent Placement in Normal Dogs
Endoscopic retrograde cholangiography (ERC) is a minimally invasive imaging modality used in humans for the diagnosis and treatment of extrahepatic bile duct obstruction (EBDO). Traditional therapy in veterinary patients has been surgical. The purpose of the present study was to describe a minimally invasive technique using ERC and endoscopic biliary stenting of the common bile duct (CBD) in normal dogs.
Six purpose-bred dogs with normal biliary tracts had duodenoscopy performed using a side-viewing duodenoscope. Under endoscopic guidance a sphincterotome was used to cannulate the CBD and pancreatic duct (PD) and contrast was used to opacify the duct using fluoroscopy. A guidewire was advanced through the catheter and up the CBD. A 5 or 7 French polyurethane stent was advanced over the guidewire into the CBD and patency was documented.
ERC was successful in 5/6 dogs ranging in weight from10.5-26 kg. Biliary stenting was possible in 4/6 dogs. No major complications occurred during the procedure. Two minor complications included the submucosal injection of contrast at the major duodenal papilla making canulation and stent placement impossible (1) or difficult (1). No dog had evidence of GI or CBD perforation. All stents were able to be removed endoscopically with traction after placement.
ERC and endoscopic biliary stenting is possible in normal dogs but difficult for those not trained in these techniques. Further investigation of this minimally invasive technique for the relief of EBDO as a future alternative to surgery is recommended.