Uncomplicated gallbladder mucoceles – is it better for prognosis to perform cholecystectomy or medically manage?

Published:

2021-06-10

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DOI

https://doi.org/10.18849/ve.v6i2.395

Abstract

PICO question

In dogs with an uncomplicated gallbladder mucocele, is the long-term survival when surgically managed superior, inferior, or equal to those medically managed?

 

Clinical bottom line

Category of research question

Treatment and prognosis

The number and type of study designs reviewed

Three papers were critically reviewed. All of the studies were retrospective analyses of medical records, two of which were cohort studies, and one which was a case control study

Strength of evidence

Weak

Outcomes reported

There is some evidence that surgical management of gallbladder mucoceles is associated with longer survival times than medically managed cases, although there is no direct analysis of uncomplicated vs complicated cases

Conclusion

We cannot clearly make a conclusion based on the available evidence. To date, there is only one retrospective analysis that directly compares the long-term survival of cases medically vs surgically managed, but this study does not separate uncomplicated vs complicated cases of gallbladder mucocele. In order to more accurately determine which type of treatment should be recommended for uncomplicated cases of gallbladder mucoceles, a prospective study comparing long-term survival with each treatment should be performed. These studies should also standardise medical management in order to more accurately compare survival time to surgical treatment

 

How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

 

Open Access Peer Reviewed

References

Allerton, F., Swinbourne, F., Barker, L., Black, V., Kathrani, A., Tivers, M., Henriques, T., Kisielewicz, C., Dunning, M. & Kent, A. (2018). Gall bladder mucoceles in Border terriers. Journal of Veterinary Internal Medicine. 32(5), 1618–1628. DOI: https://doi.org/10.1111/jvim.15249

Parkanzky, M., Grimes, J., Schmiedt, C., Secrest, S. & Bugbee, A. (2019). Long-term survival of dogs treated for gallbladder mucocele by cholecystectomy, medical management, or both. Journal of Veterinary Internal Medicine. 33(5), 2057–2066. DOI: https://doi.org/10.1111/jvim.15611

Pike, F.S., Berg, J., King, N.W., Penninck, D.G. & Webster, C.R.L. (2004). Gallbladder mucocele in dogs: 30 cases (2000–2002). Journal of American Veterinary Medical Association. 224(10), 1615–1622. DOI: https://doi.org/10.2460/javma.2004.224.1615

Smalle, T.M., Cahalane, A.K. & Köster, L.S. (2015). Gallbladder mucocoele: A review. Journal of the South African Veterinary Association. 86(1), 1318. DOI: https://doi.org/10.4102/jsava.v86i1.1318

Vol. 6 No. 2 (2021): The second issue of 2021

Section: Knowledge Summaries

Categories :  Small Animal  /  Dogs  /  Cats  /  Rabbits  /  Production Animal  /  Cattle  /  Sheep  /  Pig  /  Equine  /  Exotics  /