Keywords: cellophane banding, contrast-enhanced computed tomography angiography, extrahepatic portosystemic shunt, volume-rendered imaging. Preprandial and postprandial bile acids were 25 and 12.5 µmol/ℓ, respectively (aforementioned respective reference ranges), 3 months post-surgery. CTA demonstrated an increased portal vein diameter (3.79-5.27 mm) measured at the level between the origin of the shunt and the porta of the liver. VRI revealed no evidence of portosystemic communication on the level of a cellophane band and caudal to the cellophane band. Follow-up single-phase CTA with VRI was obtained 10 weeks after surgery. Surgery was performed using cellophane banding without attenuation. CTA revealed a 3.66 mm-diameter shunt measured at the level of the termination of the shunt and a 3.79 mm-diameter portal vein measured at the level between the origin of the shunt and the porta of the liver. VRI revealed a portocaval shunt originating just cranial to a tributary of the gastroduodenal vein and draining into the caudal vena cava at the level of the epiploic foramen. Single-phase contrast-enhanced computed tomography angiography (CTA) with volume-rendered imaging (VRI) was obtained. Preprandial and postprandial bile acids were 44.2 and 187.3 µmol/ℓ, respectively (reference ranges 0-10 and 0-20 µmol/ℓ, respectively). Urinary calculi were composed of ammonium biurate. IVDepartment of Veterinary Surgery, College of Veterinary Medicine, Konkuk University, 1 Hwayang-dong, Gwangjin-gu, Seoul 143-701, KoreaĪ 4-year-old, 1.8 kg, male, castrated Maltese was presented for evaluation of urolithiasis. IIIDepartment of Physics and Astronomy and Center for Theoretical Physics, Seoul National University, Seoul 151-747, Korea IIVIP Animal Hospital, Seoul 130-840, Korea IDepartment of Veterinary Surgery, College of Veterinary Medicine, and the Veterinary Science Research Institute, Konkuk University, Seoul 143-701, Korea H Yoon I Y Choi II H Han III S Kim II K Kim IV S Jeong IV, * on behalf of the American College of Veterinary Internal Medicine.CLINICAL COMMUNICATION KLINIESE MEDEDELINGĬontrast-enhanced computed tomography angiography and volume-rendered imaging for evaluation of cellophane banding in a dog with extrahepatic portosystemic shunt Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. Liver meta-analysis portosystemic shunt systematic review treatment. Blinded randomized studies comparing different treatment modalities, which routinely include postoperative imaging to assess cEHPSS closure and acquired portosystemic shunt development are essential. Ameroid is superior to thin film band in causing EHPSS closure. The evidence base of choice of treatment of cEHPSS in dogs remains weak despite recent publications on the subject. No other comparisons were statistically significant. Regarding surgical outcome, statistically significant superiority of ameroid constrictor over thin film band was observed (P =. The quality of evidence was low and risk of bias high. Six retrospective studies (grade 4b) compared 2 techniques and 7 were abstracts (grade 5). A network meta-analysis was performed.įorty-eight studies were included. Studies were assessed for quality of evidence (study design, study group sizes, subject enrollment quality, and overall risk of bias) and outcome measures reported (perioperative outcome, clinical outcome, and surgical or interventional outcome), all reported with 95% confidence intervals. To assess the quality of evidence available in the treatment of cEHPSS, summarize the current state of knowledge with respect to outcome after cEHPSS management, and compare different treatment techniques.Ī bibliographic search was performed without date or language restrictions. A previous evidence-based review (2012) found low quality of evidence for papers assessing the treatment of cEHPSS in dogs. Several options have been proposed for the treatment of congenital extrahepatic portosystemic shunts (cEHPSS) in dogs, but formal comparisons among different treatment options are currently unavailable.
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