Cholecystoenterostomy (CCE) is recommended to establish bile duct patency by rerouting bile from the gallbladder to the intestine. It can be performed if the gallbladder is intact and not directly involved in the extrahepatic biliary tract disease process and if the hepatic and cystic ducts are patent. Fifteen dogs that underwent CCE after being diagnosed with severe obstructive hepatobiliary disease were studied retrospectively. Short-term outcome for both survivors and nonsurvivors was defined as events occurring within 20 days of surgery. The most common indication for CCE was fibrosing pancreatitis, followed by malignant disease. It was shown that the cause of underlying hepatobiliary disease was not associated with either short-term outcome or long-term survival. Eight of the 15 animals died of causes related to the surgery or hepatobiliary disease. Long-term complications included hepatic abscesses, acquired portosystemic shunts, pancreatitis, and vomiting.

COMMENTARY: This paper is a good review for the practitioner interested in learning more about a relatively uncommon surgical procedure that is not typically performed in private practice. However, this group was identified from 1981-2005, and surgical/medical standards may have evolved during this time. Since these standards were not controlled for or described in the paper, it is impossible to know whether all animals were treated the same way when a complication arose, or whether this may have affected survival. The paper makes clear, however, that prognosis is guarded at best in an animal having surgical modification of the gastrointestinal and hepatobiliary tract.-Heather Troyer, DVM, Diplomate ABVP (Canine & Feline)

Long-term survival of dogs after cholecystoenterostomy: A retrospective study of 15 cases (1981-2005). Papazoglou LG, Mann FA, Wagner-Mann C, Song KJ. JAAHA 44:67-74, 2008.