Definitive diagnosis of pancreatitis continues to be a challenge in cats. In many instances, a definitive diagnosis is only possible with histopathologic examination of tissue samples. Biopsies can be obtained via exploratory surgery; however, this is considered relatively invasive. Laparoscopy is a less invasive procedure used to obtain biopsies from various organs. The purpose of this study was to determine the clinical effects of laparoscopic pancreatic biopsy in cats. Additional goals were to ascertain whether any significant clinicopathological abnormalities arose, to establish that the punch type biopsy instrument could indeed provide adequate pancreatic tissue for histopathology, and to reassess the pancreatic biopsy site grossly and histopathologically one month later.
The study population consisted of 11 cats (6 biopsy, 5 sham operated control cats). Body weight, temperature, pulse, respiratory rate, and caloric intake were monitored for one week prior and one week after the surgical procedure. The cats were also monitored for any indications of gastrointestinal tract disturbances. At 0, 6, 24 and 72 hours post-procedure, a complete blood cell count, serum biochemistry profile, urine specific gravity and feline pancreatic lipase immunoreactivity, were evaluated.
A Wilk-Shapiro test was performed to determine if the data was normally distributed. If normally distributed, a 2 sample t-test was run on the differences between pre and post procedure parameters for experimental and control groups. If the data was not normally distributed, a Wilcoxon rank sum test was run on the differences between pre and post procedure parameters for experimental and control groups.
None of the clinical parameters deviated significantly from controls. Clinicopathological changes included statistically significant changes within the following parameters as compared to time zero : elevated blood urea nitrogen at 72 hours, decreased bicarbonate at 6 hours, and decreased total serum calcium at 24 hours in comparison to controls. The pancreatic tissue collected was deemed to provide excellent samples for histopathological analysis.
One month after the original procedure, the cats underwent a second procedure to reevaluate the effects of manipulation and biopsy on the pancreas. There were no gross pancreatic abnormalities in the control cats after one month. Of the 6 cats biopsied, gross examination revealed adhesions of omental fat (2/6), and neovascularization (3/6) at the previous biopsy sites. Moreover, when the original pancreatic biopsy sites were re-sampled one month later, during a second procedure, a subclinical mild to moderate chronic pancreatitis could be identified histopathologically in 5/6 cats.
These findings document the safety and feasibility of laparoscopic assisted pancreatic biopsy in healthy cats.