Hernon et al: The effect of flushing of the common bile duct on hepatobiliary markers and short‐term outcomes in dogs undergoing cholecystectomy for the management of gall bladder mucocele: A randomized controlled prospective study
Veterinary Surgery 5, 2023

🔍 Key Findings

Flushing the common bile duct (CBD) during cholecystectomy did not result in improved hepatobiliary markers compared to no flushing.
Cholecystectomy alone significantly reduced ALP, ALT, GGT, bilirubin, and cholesterol 3 days postoperatively (p < .05 for all).
Survival to discharge was 90.3%, with no survival difference between flushed and non-flushed groups.
Postoperative pancreatitis occurred in 12.9% of dogs, evenly distributed between groups, suggesting flushing did not increase risk.
Most common complication was regurgitation (29%), not significantly different between groups.
Free abdominal fluid had low sensitivity (29%) but moderate specificity (73%) for gallbladder rupture.
No difference in duration of hospitalization or postoperative complications between groups.
Gallbladder rupture rate was 12.9%, lower than previously reported in literature.

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Hernon et al: The effect of flushing of the common bile duct on hepatobiliary markers and short‐term outcomes in dogs undergoing cholecystectomy for the management of gall bladder mucocele: A randomized controlled prospective study
Veterinary Surgery 5, 2023

🔍 Key Findings

Flushing the common bile duct (CBD) during cholecystectomy did not result in improved hepatobiliary markers compared to no flushing.
Cholecystectomy alone significantly reduced ALP, ALT, GGT, bilirubin, and cholesterol 3 days postoperatively (p < .05 for all).
Survival to discharge was 90.3%, with no survival difference between flushed and non-flushed groups.
Postoperative pancreatitis occurred in 12.9% of dogs, evenly distributed between groups, suggesting flushing did not increase risk.
Most common complication was regurgitation (29%), not significantly different between groups.
Free abdominal fluid had low sensitivity (29%) but moderate specificity (73%) for gallbladder rupture.
No difference in duration of hospitalization or postoperative complications between groups.
Gallbladder rupture rate was 12.9%, lower than previously reported in literature.

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Multiple Choice Questions on this study

In Hernon 2023 et al., on flushing the CBD, what was the observed survival to discharge rate across both study groups?

A. 78.4%

B. 83.0%

C. 90.3%

D. 96.7%

E. 100%

Answer: 90.3%

Explanation: 28 out of 31 dogs survived to discharge, yielding a survival rate of 90.3%.

In Hernon 2023 et al., on flushing the CBD, which of the following best describes the sensitivity of ultrasonographic detection of free abdominal fluid for diagnosing gallbladder rupture?

A. 29% sensitivity, 73% specificity

B. 73% sensitivity, 29% specificity

C. 50% sensitivity, 50% specificity

D. 90% sensitivity, 60% specificity

E. 100% sensitivity, 100% specificity

Answer: 29% sensitivity, 73% specificity

Explanation: The study found that ultrasonographic free fluid had low sensitivity (29%) but moderate specificity (73%) for gallbladder rupture.

In Hernon 2023 et al., on flushing the CBD, which of the following was the most common postoperative complication in dogs undergoing cholecystectomy?

A. Pancreatitis

B. Hemorrhage

C. Seroma formation

D. Hypoxemia

E. Regurgitation

Answer: Regurgitation

Explanation: Regurgitation occurred in 29% of dogs, making it the most frequent postoperative complication.

In Hernon 2023 et al., on flushing the CBD, what was the effect of common bile duct flushing on postoperative hepatobiliary markers in dogs undergoing cholecystectomy?

A. It significantly improved ALT, ALP, and bilirubin levels

B. It increased the risk of pancreatitis

C. It had no significant impact on postoperative markers

D. It worsened postoperative bilirubin levels

E. It improved cholesterol but not ALP

Answer: It had no significant impact on postoperative markers

Explanation: Flushing the CBD did not produce any additional benefit in hepatobiliary markers compared to cholecystectomy alone.

In Hernon 2023 et al., on flushing the CBD, what was concluded regarding the routine use of CBD flushing during cholecystectomy in dogs with GBM?

A. It significantly reduced complication rates

B. It improved hepatobiliary marker normalization

C. It is recommended for all GBM cases

D. It showed no added benefit and should not be routine

E. It improved survival to discharge

Answer: It showed no added benefit and should not be routine

Explanation: The authors concluded that CBD flushing did not yield clinical or clinico-pathological benefits, and should not be routinely performed.

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