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Short-term clinical outcome of laparoscopic liver biopsy in dogs: 106 cases (2003–2013)

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  • 1 Section of Surgery, Matthew J. Ryan Veterinary Hospital, Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 2 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 3 Section of Surgery, Matthew J. Ryan Veterinary Hospital, Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 4 Section of Surgery, Matthew J. Ryan Veterinary Hospital, Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.
  • | 5 Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.
  • | 6 Section of Surgery, Matthew J. Ryan Veterinary Hospital, Department of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

Abstract

OBJECTIVE To describe the operative technique, complications, and conversion rates for laparoscopic liver biopsy (LLB) in dogs and evaluate short-term clinical outcome for dogs that underwent the procedure.

DESIGN Retrospective case series.

ANIMALS 106 client-owned dogs.

PROCEDURES Medical records were reviewed to identify dogs that underwent an LLB with a single-port or multiport technique at either of 2 veterinary teaching hospitals from August 2003 to September 2013. Demographic and laboratory data, preoperative administration of fresh frozen plasma, procedural and diagnostic information, intraoperative complications, and survival to discharge were recorded. The LLB specimens were obtained with 5-mm laparoscopic biopsy cup forceps and a grasp-and-twist technique.

RESULTS Prior to surgery, 25 of 94 (27%) dogs had coagulopathy (prothrombin time or partial thromboplastin time greater than the facility reference ranges, regardless of platelet count). Twenty-one dogs were thrombocytopenic, 14 had ascites, and 14 received fresh frozen plasma transfusion before surgery. In all cases, biopsy samples collected were of sufficient size and quality for histopathologic evaluation. Two dogs required conversion to an open laparotomy because of splenic laceration during initial port placement. One hundred one of 106 dogs survived to discharge; 5 were euthanized during hospitalization owing to progression of liver disease and poor prognosis.

CONCLUSIONS AND CLINICAL RELEVANCE Single-port and multiport LLB were found to be effective, minimally invasive diagnostic techniques with a low rate of complications. Results suggested LLB can be safely used in dogs with underlying coagulopathies and advanced liver disease.

Abstract

OBJECTIVE To describe the operative technique, complications, and conversion rates for laparoscopic liver biopsy (LLB) in dogs and evaluate short-term clinical outcome for dogs that underwent the procedure.

DESIGN Retrospective case series.

ANIMALS 106 client-owned dogs.

PROCEDURES Medical records were reviewed to identify dogs that underwent an LLB with a single-port or multiport technique at either of 2 veterinary teaching hospitals from August 2003 to September 2013. Demographic and laboratory data, preoperative administration of fresh frozen plasma, procedural and diagnostic information, intraoperative complications, and survival to discharge were recorded. The LLB specimens were obtained with 5-mm laparoscopic biopsy cup forceps and a grasp-and-twist technique.

RESULTS Prior to surgery, 25 of 94 (27%) dogs had coagulopathy (prothrombin time or partial thromboplastin time greater than the facility reference ranges, regardless of platelet count). Twenty-one dogs were thrombocytopenic, 14 had ascites, and 14 received fresh frozen plasma transfusion before surgery. In all cases, biopsy samples collected were of sufficient size and quality for histopathologic evaluation. Two dogs required conversion to an open laparotomy because of splenic laceration during initial port placement. One hundred one of 106 dogs survived to discharge; 5 were euthanized during hospitalization owing to progression of liver disease and poor prognosis.

CONCLUSIONS AND CLINICAL RELEVANCE Single-port and multiport LLB were found to be effective, minimally invasive diagnostic techniques with a low rate of complications. Results suggested LLB can be safely used in dogs with underlying coagulopathies and advanced liver disease.

Contributor Notes

Address correspondence to Dr. Runge (Jrunge@vet.upenn.edu).