Multiple biliary duct hamartomas in a cat resulting in a hepatic mass: A case report.

A 13-year-old, male neutered domestic short-haired cat was diagnosed with multiple biliary duct hamartomas after liver lobectomy for a suspected malignant hepatic mass. Distinguishing ultrasonographic findings included a lobular, mostly well-defined, heterogeneous, predominantly hyperechoic, left hepatic mass. Computed tomography (CT) confirmed the presence of a lobular, well-defined, fluid to soft tissue attenuating, heterogeneously hypoenhancing left divisional hepatic mass. Grossly, a large left sided multilobular pale pink gelatinous hepatic mass was surgically excised. Histopathologically, the mass was composed of irregular cystic spaces lined by cuboidal epithelium and separated by mature regular fibrous tissue. Three months following surgery there was no evidence of recurrence or progression of disease on repeat abdominal ultrasound (AUS).

Central and left division hepatectomies in two dogs.

OBJECTIVE: To describe the management of extensive hepatectomy in 2 dogs. ANIMALS: A 10-year-old female intact mixed-breed dog (case 1) and an 11-year-old male castrated mixed-breed dog (case 2) were presented for surgical evaluation following diagnosis of a hepatic mass. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: 16 months before presentation, case 1 had undergone a left lateral liver lobectomy, which resulted in an incomplete resection of hepatocellular carcinoma. Both dogs underwent surgical excision of the liver mass. TREATMENT AND OUTCOME: In case 1, surgery consisted of the removal of the remaining left medial lobe, as well as the central division. Case 2 received a complete left and central division hepatectomy. Histopathology confirmed a diagnosis of hepatocellular carcinoma in both dogs. Liver enzyme resolution and lack of tumor recurrence were confirmed with chemistry panel and abdominal ultrasonography in both dogs. CLINICAL RELEVANCE: This case report describes, for the first time, the clinical management and outcome of extensive hepatectomy in 2 dogs. We propose that extensive hepatectomy, staged or synchronous, is possible in a clinical setting.

Hepatic lobectomy in dogs using a stapling device with a vascular cartridge: a retrospective study of 13 cases.

CASE HISTORY: Medical records of two veterinary hospitals in Canada were reviewed to identify cases of dogs that underwent liver lobectomy via open laparotomy using the Endo GIA surgical stapling device with a vascular cartridge (height of open and closed staples: 2.5 and 1.0 mm, respectively) between January 2016 and June 2018. Mean age at the time of surgery of the dogs (n = 13) included in the study was 10.4 (SD 1.5; min 7.9, max 12.8) years and mean body weight was 14 (min 3.9, max 37.8) kg. CLINICAL FINDINGS: Liver masses requiring hepatic lobectomy were identified in 12 dogs by abdominal ultrasound examination. The remaining dog required a lobectomy of the right medial liver lobe to address leakage from the right medial lobe hepatic duct that occurred as a complication of cholecystectomy to treat a ruptured gallbladder mucocoele. TREATMENT AND OUTCOME: Complete liver lobectomy of 14 lobes (11 from the left hepatic division) in 12 dogs and partial lobectomy of one lobe in one dog was performed via open laparotomy using the Endo GIA device. The mean surgical time, including concurrent procedures, was 50 (SD 17; median 45, min 28, max 91) minutes. The most common intra-operative complication was oozing from the transected liver parenchyma in 6/13 dogs, which was mild in all cases. Five dogs experienced minor post-operative complications. No major peri- or post-operative complications occurred, and no patients required surgical re-exploration. All patients survived until discharge and were alive at the 2-week follow-up for suture removal. CLINICAL RELEVANCE: Use of the Endo GIA stapling device with a vascular cartridge is feasible for liver lobectomy of the left hepatic division and in this study had low rates of intra-operative and post-operative complications. The Endo GIA stapling device is a viable option for this type of liver lobectomy in dogs. Though successful, the small number of central (two lobes) and right (one lobe) hepatic division lobectomies in this study precludes us from drawing definitive conclusions about the feasibility of this technique on these divisions.

Association between divisional location and short-term outcome of liver mass resection in 124 dogs.

OBJECTIVE: To evaluate the association between divisional location of liver masses on short-term outcomes after surgical excision. STUDY DESIGN: Retrospective case series. ANIMALS: Client-owned dogs (n = 124). METHODS: Records were reviewed for demographics, surgical findings, and outcomes. The associations between mass location and mortality, intraoperative complications, and postoperative complications were tested with multivariable logistic regression models. RESULTS: Liver masses (124) were more common in the left (72) division than the central (34) and right (18) divisions. Median follow up was 286 (range: 14 to 2043) days. Intraoperative complications occurred in 14/124 dogs (11.3%) and postoperative complications in 35/122 dogs (28.7%). No association was detected between mass location and mortality in 8/124 dogs (6.5%). Postoperative complications were more likely if the incision extended to the thorax (P < .001), which was more common during resection of right divisional masses (P = .020). Postoperative complications were less likely when surgery was performed with a thoracoabdominal (TA) stapler (P = .005), by a specialist surgeon (P = .033), and in heavier dogs (P = .027). The odds of intraoperative complications were 19 times higher when surgery was performed without a TA stapler (P = .006). Intraoperative complications were less commonly associated with left (P = .007), but not central (P = .0504) divisional masses than right divisional masses. CONCLUSION: Right divisional masses were prone to intraoperative but not postoperative complications. CLINICAL SIGNIFICANCE: Clinicians should anticipate an increased risk of intraoperative complications when planning treatment of right divisional masses.

Paracostal versus ventral midline approach for caudate liver lobectomy in the rabbit.

OBJECTIVE: To describe the paracostal approach to caudate liver lobectomy in rabbits and compare the outcome of paracostal versus ventral midline approach for caudate liver lobectomy in rabbits with caudate liver lobe torsion (LLT). STUDY DESIGN: Cadaveric and retrospective study. ANIMALS: Normal rabbit cadavers (n = 5) and rabbits with caudate LLT (n = 22). METHODS: Cadavers - a right paracostal or ventral midline approach was made. Accessibility of the caudate liver lobe and relationship to the gastrointestinal (GI) tract were assessed. Clinical LLT cases - 9 cases were treated via the paracostal approach and 13 were treated via the ventral midline approach. Medical records (January, 2018 to October, 2021) were reviewed. Anesthesia and surgical times, mortality rate, and relevant clinical data were compared between groups. RESULTS: In cadavers, caudate liver lobectomy was feasible through a paracostal approach without retraction of the GI tract. In clinical cases, there was no difference in anesthesia time (P = 0.1397) or surgical time (P = 0.9462) between groups. All rabbits that underwent paracostal approach survived to discharge. Mortality was lower (P = .053) and postoperative time until eating was shorter (P = .0238) for patients undergoing paracostal approach. CONCLUSION: Rabbits experienced lower mortality and shorter time until eating when treated through a right paracostal approach compared to the ventral midline approach. The paracostal approach resulted in minimal to no manipulation of the GI tract. CLINICAL SIGNIFICANCE: A right paracostal approach for caudate liver lobectomy in rabbits provides good exposure while avoiding GI tract manipulation. This approach may result in improved survival and earlier eating in rabbits with caudate LLT.

Computed angiographic variations in hepatic venous vasculature in dogs.

OBJECTIVE: To identify the number of hepatic veins draining directly or indirectly into the caudal vena cava Thank you (CVC) using computed tomography angiography (CTA) in dogs. STUDY DESIGN: Retrospective clinical study. ANIMALS: Client-owned dogs (n = 77). METHODS: Abdominal CTA images were analyzed. Retrospective convenience sampling was performed using archived clinical cases to determine the number of hepatic veins in each liver lobe. RESULTS: A median of 2 vessels from the right lateral lobe (range: 1-4) and the caudate process of the caudate lobe (range: 1-5) drained directly into the CVC. In the quadrate lobe, most common patterns consisted of 1 vessel directly draining to the CVC or indirectly via the left hepatic vein (LHV), and a vessel from quadrate lobe and right medial lobe merging into 1 vessel draining into the CVC or the LHV. A median of 3 vessels in the left lateral lobe (range: 2-8) and a median of 1 vessel in the left medial lobe (range: 1-3) drained into the LHV. In the papillary process of the caudate lobe, a median of 1 (range: 1-2) vessel drained directly into the CVC or the LHV. CONCLUSION: The draining pattern of hepatic veins varied widely in all liver lobes, especially the left lateral liver lobe. CLINICAL SIGNIFICANCE: Veterinary surgeons should consider the potential presence of multiple hepatic veins and their draining pattern when performing hilar liver lobe resection. Attentive evaluation of a preoperative CTA is recommended for surgical planning.

Partial hepatectomy for treatment of multiple liver abscess in a calf: a case report.

BACKGROUND: Umbilical vein bacterial infections may cause liver abscesses during bacterial ascent. A single liver abscess can be surgically treated by marsupialization, but a risk of recurrence or non-healing remains. Moreover, there is no effective treatment for multiple abscesses. CASE PRESENTATION: A 17-day-old Holstein female calf exhibited reduced general condition, swelling and drainage of the umbilicus, and pressure sores in the area of the carpus, resulting in reluctance to stand up. The umbilicus showed pain at palpation; deep abdominal palpation indicated a swollen umbilical vein coursing from the umbilicus toward the liver. Ultrasonography confirmed a swollen umbilical vein with pus accumulation and multiple abscesses in the liver. Contrast-enhanced computed tomography (CT) examination confirmed that the swollen umbilical vein with fluid continued to the liver, and multiple unenhanced lesions, most likely abscesses, were confirmed in the liver. Partial hepatectomy was performed to remove as many abscesses as possible. For the resection, a vessel sealing device (LigaSureTM) was used to excise a part of the left liver lobe. As we could not remove all the abscesses in the liver during the operation, cefazolin sodium (5 mg/kg) was administered for 14 days after surgery. Post-operatively, blood accumulation was observed in the abdominal cavity, but no signs of peritonitis were found. The calf returned to the farm on day 38 after surgery. Follow-up information was obtained after 1 year, and complications were not reported. CONCLUSIONS: To our knowledge, this is the first report of partial hepatectomy using a vessel sealing device for a calf with multiple liver abscesses. This case report suggests that the combination of partial hepatectomy and long-term administration of antibacterial drugs may restore the health of calves with multiple liver abscesses.

Feasibility of laparoscopic liver lobectomy in dogs.

OBJECTIVE: To determine the feasibility of laparoscopic liver lobectomy (LLL) in dogs by using canine cadavers and to describe the clinical application in dogs with liver disease. STUDY DESIGN: Ex vivo experiment and descriptive case series. SAMPLE POPULATION: Twelve canine cadavers and six client-owned dogs. METHODS: Cadavers underwent LLL with an endoscopic stapler. The percentage of liver lobe resected was determined by volume. The distance from the staple line to hilus was measured. Medical records of dogs undergoing LLL were reviewed. RESULTS: In cadavers ≤15 kg, left lateral lobectomy completeness was 87.3% (84.6%-96.6%), and remaining median (interquartile range) hilar length was 1 cm (0.25-1.75). Left medial lobectomy completeness was 72.5% (66.7%-80%), and remaining hilar length was 1.6 cm (0.47-1.75). Central division resection completeness was 68.3% (60%-92.9%), and remaining hilar length was 2.7 cm (0.8-5). Laparoscopic liver lobectomy was not feasible for right division lobes and in cadavers >15 kg. Five dogs with peripheral quadrate or left lateral lobe masses underwent stapled, partial laparoscopic lobectomy (30%-90%). One dog underwent stapled, left lateral lobectomy (90%) after open procedure conversion. Histopathological diagnoses included hepatocellular carcinoma (3), nodular hyperplasia (1), biliary cyst adenoma (1), and fibrosis (1). CONCLUSION: Laparoscopic liver lobectomy of the left and central divisions is feasible in cadavers ≤15 kg with an endoscopic stapler. Partial LLL of the left and central divisions is feasible in select dogs with liver disease. CLINICAL SIGNIFICANCE: Laparoscopic liver lobectomy may be a viable alternative to laparotomy in small-to-medium size dogs with peripheral liver masses of the left and central divisions.

Use of a cavitron ultrasonic surgical aspirator for parenchyma-sparing and complex liver resections in dogs.

OBJECTIVE: To report the clinical use of a cavitron ultrasonic surgical aspirator (CUSA) for the resection of hepatic lesions in dogs. STUDY DESIGN: Clinical prospective study. ANIMALS: Eleven client-owned dogs. METHODS: Dogs requiring a hepatic nodulectomy, segmentectomy, and/or a lobectomy (including complex lobectomies) were enrolled. The number and location of procedures, blood loss, duration of surgery, and short-term complications were recorded. RESULTS: Dogs underwent a mean of 2.3 ± 1.1 procedures. All masses were amenable to surgical excision regardless of their location and their relationship with major hepatic vessels. Dogs lost a median of 77 mL of blood (9.9-161), which corresponded to 4.3% of blood volume (0.8%-23.2%). The dog with the highest blood loss survived without requiring transfusion. The median duration of all CUSA procedures was 33.5 minutes (15-82). Short-term outcomes were assessed for the first 15 days, during which two complications were diagnosed. Cholangiohepatitis was diagnosed in one dog and resolved after medical management, and another dog developed necrotic pancreatitis and died. CONCLUSION: Liver parenchyma-sparing nodulectomies and segmentectomies and liver lobectomies including complex lobectomies were achieved with a CUSA in all dogs. CLINICAL SIGNIFICANCE: Use of a CUSA can be considered as an alternative for the removal of hepatic lesions in dogs.

Effect of hydrogen-rich saline on apoptosis induced by hepatic ischemia reperfusion upon laparoscopic hepatectomy in miniature pigs.

Hepatic ischemia reperfusion injury (HIRI) occurs commonly in liver surgery and liver transplantation. Hydrogen, a safe and effective antioxidant, exerts a protective effect against liver injury. In this study, we investigated the role of hydrogen-rich saline (HRS) in apoptosis in a miniature pig model of laparoscopic HIRI upon hepatectomy. Bama miniature pigs were randomly assigned to sham, I/R and HRS groups. The pigs received 10 mL/kg HRS by portal venous injection 10 min before reperfusion and at 1 d, 2 d, and 3 d after surgery. The results showed that HRS treatment significantly decreased serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) activity and TUNEL-positive cells. Upon HRS treatment, the expression of P53 and Bax mRNA and protein by RT-qPCR and Western blot was markedly decreased, whereas the expression of bcl-2 mRNA and protein was significantly increased. Moreover, Caspase-3 and Caspase-9 activities were significantly decreased upon treatment with HRS. In conclusion, the results indicate that HRS could alleviate liver injury and improve liver function via inhibiting apoptosis after laparoscopic HIRI and hepatectomy injury in miniature pigs.

Histopathologic characteristics of biopsies from dogs undergoing surgery with concurrent gross splenic and hepatic masses: 125 cases (2012-2016).

OBJECTIVE: To investigate the histopathologic characteristics of concurrent splenic and liver masses in dogs undergoing splenectomy and liver mass biopsy/resection. Medical records of 125 client-owned dogs found to have splenic mass or masses and a liver mass or masses during surgery were examined. Signalment (age, sex, breed), body weight, and results of histopathology were recorded for all dogs. RESULTS: Twenty-seven percent (34/125) of the dogs in this study had no evidence of malignancy in either the liver or the spleen. Sixty of 125 dogs (48.0%) had malignancy in the spleen and liver, and 56 (56/60, 93.3%) of those dogs had the same malignancy in both organs. Signalment was similar to that in other reports of splenic pathology. In this clinical population of dogs, 27% of dogs with concurrent gross splenic and liver masses discovered intraoperatively had benign lesions in both locations and therefore had a favorable prognosis.

Partial hepatectomy in a calf with an omphalocele: case report / Hepatectomia parcial em bezerra portadora de onfalocele: relato de caso

An omphalocele is a defect in the closure of the abdominal wall during the embryonic stage, preventing the return of some abdominal organs to the cavity. In stillborn animals, the involvement of the liver in the omphalocele has been reported. The aim of the present study is to report the success of a partial liver resection in a female bovine at two days of age which presented an omphalocele at birth. Surgical intervention was indicated to reduce and suture the abdominal wall. During the surgical procedure, the presence of hard, reddish tissue was noted inside the sac covered by the amniotic membrane, with characteristics consistent with hepatic parenchyma. Due to the impossibility of reducing the contents added to the suggestion of tissue infection, we elected to perform a partial resection. The histopathological examination confirmed that the resected tissue was of the hepatic parenchyma. Antibiotic and systemic anti-inflammatory therapies were performed post-surgery. Fifteen days after surgery, infection was detected at the surgical site in addition to abdominal wound dehiscence; surgical reintervention was performed. On physical examination, carried out 4 months after the second operation, the heifer presented normal development for the species. In conclusion, omphalocele may contain liver. Ectopic liver is an extremely rare condition. Surgical treatment in the presented case focused on umbilicus with exploration of the abdominal cavity appeared to be sufficient.(AU)

A onfalocele é um defeito no fechamento da parede abdominal durante a fase embrionária, não permitindo o retorno de alguns órgãos abdominais à cavidade. O envolvimento do fígado em onfalocele tem sido relatado, porém em animais natimortos. Com o presente estudo, objetiva-se relatar uma ressecção parcial do fígado realizada com sucesso em uma fêmea bovina com dois dias de idade apresentando onfalocele ao nascimento. Foi indicada a intervenção cirúrgica para a redução e rafia da parede abdominal. Durante o procedimento cirúrgico, notou-se, no interior do saco recoberto pela membrana amniótica, a presença de tecido firme, de coloração avermelhada, com características compatíveis com parênquima hepático. Devido à impossibilidade de redução do conteúdo e sugestão de infecção do tecido encontrado, optou-se pela ressecção parcial dele. O exame histopatológico confirmou tratar-se de parênquima hepático o tecido resseccionado. No pós-cirúrgico, realizaram-se terapias antibiótica e antiinflamatória sistêmicas. Após 15 dias do procedimento cirúrgico, foi detectada infecção do sítio operatório e deiscência da sutura abdominal, sendo realizada reintervenção cirúrgica. No exame físico, realizado no animal após quatro meses da segunda intervenção cirúrgica, constatou-se desenvolvimento normal para a espécie. Conclui-se que o fígado pode ser conteúdo da onfalolocele, sendo uma condição extremamente rara. O tratamento cirúrgico no caso apresentado, com exploração da cicatriz umbilical e da cavidade abdominal, foi suficiente.(AU)

Current concepts in hepatobiliary surgery.

The most common hepatic procedures performed in companion animals are liver biopsies and partial hepatectomies. Surgery of the biliary tract most often involves the gallbladder, although surgical intervention of the bile duct may also be performed. Hepatobiliary surgery is often challenging, being performed in patients with significant systemic illness and associated with potentially life-threatening complications. An in-depth understanding of the regional anatomy, use of a team concept for patient management, particularly for patients undergoing partial hepatectomy surgery, and provision of intensive perioperative monitoring and support helps minimize complications and maximize outcome.

Desarrollo de un modelo experimental de ligadura portal asociada a transección parenquimatosa (ALPPS) en ratas / Development of an experimental model of portal vein ligation associated with parenchymal transection (ALPPS) in rats

ANTECEDENTES: La insuficiencia hepática postresección es una de las principales causas de muerte en el postoperatorio de una hepatectomía mayor. La técnica ALPPS aparece como una estrategia prometedora para evitarla, pero no existen estudios experimentales al respecto. El objetivo del trabajo es desarrollar un modelo experimental de ALPPS en ratas. MÉTODO: Se desarrolló un modelo experimental de ALPPS en 30 ratas Sprague Dawley. Se realizó la ligadura de la rama portal izquierda del lóbulo medio (LM), con lo cual se demarca el sector izquierdo (SILM) y derecho (SDLM); posteriormente se realizó la transección parenquimatosa por la línea isquémica. Se evaluaron el peso del animal, el volumen y peso del LM y de ambos. Sacrificio a los 3, 7 y 14 días (10 por grupo). RESULTADOS: No se presentaron complicaciones hemorrágicas ni ascitis en el postoperatorio. El incremento del volumen del LM fue del 24,1; 86,9 y 120,4% a los 3, 7 y 14 días. El SDLM (no ligado) se incrementó un 34,4; 78,8 y 102,0% a 3, 7 y 14 días. El SILM disminuyó un 42,6; 64,8, y 79,3% en los días 3, 7 y 14. CONCLUSIÓN: La realización del ALPPS fue posible en ratas, logrando los resultados esperados. Futuros estudios son necesarios para compararlo con la técnica de hepatectomía en 2 tiempos

BACKGROUND: Liver failure migth be a cause of death after major hepatectomies. The ALPPS technique appears to be a promising strategy to avoid it, however no experimental studies supporting this procedure have been previously described. The aim was to develop an experimental model of ALPPS in rats. Method. Experimental. A total of 30 Sprague Dawley rats were used. To develop the ALPPS procedure, ligation of the left portal branch of the middle lobe (LM) was performed. This demarcates the left side (SILM) from the right side (SDLM); parenchyma transection was performed following the demarcated line. The animal's weight, volume and weight of both LM were analyzed. Sacrifice at 3, 7 and 14 days after the procedure (10 per group) was performed. RESULTS: No bleeding or ascites were observed during the postoperative period. The LM increased by 24.1, 86.9 and 120.4% at 3, 7 and 14 days. The SDLM increased by 34.4, 78.8 and 102.0% at 3, 7 and 14 days. The SILM decreased 42.6, 64.8, and 79.3% at day 3, 7 and 14 days respectively. CONCLUSION: The ALPPS procedure can be performed in rats, achieving the expected results. Comparison studies to 2 staged hepatectomy will be necessary

Laparoscopic left hepatectomy in swine: a safe and feasible technique.

A purely laparoscopic four-port approach was created for left hepatectomy in pigs. A polyethylene loop was placed on the left two hepatic lobes for traction and lift. Next, penetrating ligation of the lobes using of a double row of silk sutures was performed to control bleeding. A direct hepatic transection was completed using a monopolar hook electrode without meticulous dissection of the left hepatic vein. The raw surface of the liver was coagulated and sealed with fibrin glue. Lobes were retrieved through an enlarged portal. Laparoscopic hepatic lobectomy was completed in all pigs without the use of specialized instruments and with a mean operative time of 179 ± 9 min. No significant perioperative complications were observed. The average weight of each resected lobe was 180 ± 51 g. Complete blood count as well as serum organics and enzyme levels normalized after about 2 weeks. During necropsy, adhesion of the hepatic raw surface to the gastric wall and omentum were observed. No other abnormalities were identified. This minimally invasive left hepatectomy technique in swine could serve as a useful model for investigating liver diseases and regeneration, and offer preclinical information to improve hepatobiliary surgical procedures.

The ileum positively regulates hepatic regeneration in rats

To test the hypothesis that liver regeneration after partial hepatectomy can be influenced by the ileum. METHODS: Eighteen Wistar rats were distributed into groups of six animals: 1 - ileum resection+ hepatectomy 2/3; 2 - hepatectomy 2/3, and 3 - sham. Anesthesia with ketamine and xylazine i.p., aseptic technique, analgesia with meperidine (10mg/kg s.c.). On day 6, serum ALT, AST, alkaline phosphatase (AP) and albumin were measured. Liver regeneration and hepatocyte mitosis were quantified. Statistical analysis with ANOVA and Tukey tests, with significance p<0.05. RESULTS: In group hepatectomy+ileal resection, ALT, AST and AP were 180.6±24.9, 58.6±3.1 and 254.6±46.6 respectively. They were significantly higher than in the hepatectomy group, whose values were 126.0±16.5, 44.1±3.9 and 163.5±8.6, respectively (p<0.001). Albumin levels were not significantly different among groups. Liver regeneration in hepatectomy group (94.17%) was statistically higher (p<0.001) than in ileal resection+hepatectomy group (55.96%). In the latter group the mitosis of hepatocytes were significantly less frequent than in the hepatectomy group. CONCLUSION: The data confirm that the ileum positively influence on liver regeneration in rats undergoing hepatectomy.

Outcome following liver lobectomy using thoracoabdominal staplers in cats.

OBJECTIVES: To present outcomes and complications following liver lobectomy using thoracoabdominal staplers in cats, to identify factors associated with survival time and to confirm safety and feasibility. METHODS: Retrospective analysis of case records (n=18) of cats that underwent liver lobectomy with a thoracoabdominal stapler. RESULTS: Fourteen of the 18 cats (78%) survived to discharge. Median survival time was 136·5 days. On log-rank univariate analysis, preoperative abdominal fluid (P=0·002), preoperative anaemia (P=0·03) and perioperative transfusion (P=0·01) were associated with decreased survival time. Perioperative anaemia was common (89%), and rate of transfusion during hospitalisation was 61%. Clinical signs of illness, azotaemia, elevated liver enzyme activities and malignant neoplasia did not appear to impact survival; however, anaemia, abdominal fluid and transfusion may be associated with decreased survival time. CLINICAL SIGNIFICANCE: Liver lobectomy using thoracoabdominal staplers was effective in removal of hepatic lesions and all cats survived surgery. Outcome was negatively associated with preoperative abdominal fluid (haemorrhagic and non-haemorrhagic), preoperative anaemia or perioperative transfusion. Surgeons should be prepared to employ ancillary methods of haemostasis to augment the staple line, and need for blood transfusion should be anticipated.

Preparación de una matriz extracelular tridimensional por descelularización de hígados de conejos / Preparación de una matriz extracelular tridimensional por descelularización de hígados de conejos / Preparation of a three-dimensional extracellular matrix by decellularization of rabbit livers

Introducción: el número de hígados trasplantables es insuficiente para satisfacer las necesidades actuales de la demanda de injerto. La búsqueda de alternativas terapéuticas ha generado diferentes líneas de investigación, una de ellas es la utilización de matrices biológicas tridimensionales descelularizadas y la posterior siembra celular para obtener un órgano funcional. Objetivo: obtención de un protocolo de descelularización de hígado de conejo que genere una matriz hepática tridimensional. Métodos: una combinación de detergentes (Triton X-100 y SDS), agentes físicos y enzimáticos se utilizaron para descelularizar hígados de conejo. Los órganos se pefundieron en forma retrógrada con distintos agentes químicos durante 68 horas. Luego los hígados se examinaron por técnicas morfológicas (microscopía óptica y electrónicade barrido) y bioquímicas (cuantificación de ADN) para evaluar una correcta descelularización así como la obtención de una matriz extracelular preservada. Resultados: la observación macroscópica del órgano permitió inferir la descelularización del mismo. Las tinciones macroscópicas utilizadas mostraron una correcta conservación de los árboles biliar y vascular. Por otro lado, la observación microscópica del hígado permitió corroborar los resultados macroscópicos observados, la tinción de hematoxilina-eosina mostró ausencia de células y de material nuclear así como la presencia de la tríada portal. La tinción de Wilde evidenció la conservación de las fibras de reticulina en la matriz descelularizada. Asimismo, la microscopía electrónica de barrido reveló una cápsula de Glisson conservada y la descelularización de la cuantificación de ADN fue inferior al 10 % en el hígado descelularizado con respecto al hígado control. Finalmente, el tiempo utilizado para la descelularización fue inferior a las 96 horas. Conclusiones: el protocolo de descelularización propuesto fue apropiado ya que se verificó una ausencia de células y una matriz hepática con conductos vasculobiliares conservados y con una arquitectura tridimensional adecuada para una futura siembra celular(AU)

Introduction: the availability of transplantable livers is not sufficient to fulfill the current demand for grafts, with the search for therapeutic alternatives having generated different lines of research, one of which is the use of decellularized three-dimensional biological matrices and subsequent cell seeding to obtain a functional organ. Objective: to produce a decellularization protocol from rabbit liver to generate a three-dimensional matrix. Methods: a combination of physical, chemical (Triton X-100 and SDS) and enzymatic agents to decellularize rabbit livers was used. After 68 h of retrograde perfusion, a decellularized translucent matrix was generated. To evaluate if the decellularization protocol was successful, with the extracellular matrix being preserved, we carried out histological (light microscopy and scanning electron microscopy) and biochemical (DNA quantification) studies. Results: the decellularization process was verified by macroscopic observation of the organ using macroscopic staining, which revealed a correct conservation of bile and vascular trees. A microscopic observation corroborated these macroscopic results, with the hematoxylin- eosin staining showing no cells or nuclear material and the presence of a portal triad. Wilde’s staining demonstrated the conservation of reticulin fibers in the decellularized matrix. In addition, scanning electron microscopy revealed a preserved Glisson’s capsule and a decellularized matrix, with the DNA quantification being less than 10 % in the decellularized liver compared to control. Finally, the time taken to develop the decellularization protocol was less than 96 hours. Conclusions: the proposed decellularization protocol was correct, and was verified by an absence of cells. The hepatic matrix had preserved vascular and bile ducts with a suitable three-dimensional architecture permitting further cell seeding(AU)

Clinical evaluation of a pre-tied ligating loop for liver biopsy and liver lobectomy.

OBJECTIVES: The aim of this prospective case series was to evaluate the suitability of a pre-tied ligating loop for liver biopsy or partial or complete liver lobectomy via midline coeliotomy for diagnosis or treatment of hepatic disease. METHODS: Nine client-owned animals (six dogs and three cats) in which liver biopsy or partial or complete liver lobectomy was performed using a 2-0 Polysorb™ pre-tied ligating loop (SurgiTie™; Covidien) via midline coeliotomy were included. The fit of the loop, space for incision and presence and character of bleeding from the incised surface were assessed. Pre- and postoperative haematocrit and peri-operative complications were noted. Dimensions, histopathology and mineral analysis of acquired specimens were reviewed. RESULTS: The pre-tied ligating loop was successfully employed for liver biopsy and resection of torsed liver lobes and neoplastic tissue. Dirty margins were obtained in one case in which complete resection of neoplastic tissue was the primary goal. Few perioperative complications were noted, the most common being generalised oozing from the cut surface in four cases, effectively controlled with local haemostasis. CLINICAL SIGNIFICANCE: The pre-tied ligating loop is a versatile and safe method for liver biopsy or lobectomy. As with other surgical techniques, alternative methods of haemostasis should always be available.

[Liver abscess in a dog. A case report]. / Leberabszess bei einem Hund. Ein Fallbericht.

The presented case report describes diagnostic and therapy of a liver abscess in a male Golden Retriever dog. The dog was adversely affected by fever, apathy, and vomitus. Diagnostic imaging including radiography, sonography and computed tomography, revealed an abscess-forming lesion of 10 × 5 cm in the left middle liver lobe with detectable multiple gas accumulation within the lesion. The surgical therapy included lobectomy with adjacent omentopexy. Four days after the operation the dog was discharged in a good general condition and with physiological body temperature. Detecting multiple gas accumulation in circular, inhomogeneous lesions by sonography allowed confirmation of the diagnosis. Surgical removal of the affected liver lobe led to recovery of the patient. In human medicine, less invasive methods are preferred, e.g. percutaneous drainage and alcoholization of the lesion. Exclusive medicamentous therapy yields the worst outcome in humans.