Surgical removal of the gall bladder is called cholecystectomy. Most of us have heard of gall bladder surgery in people. It is not as common a surgery in animals. This page has pictures of a surgery to remove the gall bladder in a dog. At the end of this page you can see what gall stones look like.
Graphic surgical pictures on this page.
Our patient is an 11 year old Silky Terrier that came to us with some significant symptoms. They included anorexia for several days and lethargy. Her initial blood panel showed high elevations in Alk Phos., AST, and bilirubin.
Her blood panel is typical of a dog with this problem. You can see the significant elevations in her liver enzymes and bilirubin. Even the electrolytes are abnormal.
Her urinalysis showed significant amounts of bilirubin
We could see hepatomegaly on her radiograph. Initial treatment consisted of antibiotics, fluids, vitamin supplements, and I/D food. Heather rapidly got better on the treatment.
This is what the liver looks like on an abdominal radiograph
She had a recurrence of the problem 3 weeks later. At that time an ultrasound was performed and it was determined that she had a problem with her gall bladder.
Her gall bladder, the dark area on the top left had a problem. The line in the center is measuring the size of her common bile duct, which is large in her case.
This is her ultrasound report
She responded well to treatment with antibiotics and actigoll. When her enzyme test were almost back to the normal range we removed her gall bladder.
Before we do any surgery on the liver we make sure the clotting system of the body is working well. The liver is intimately involved with the bodies clotting mechanism, and we need to make sure we are not going to encounter a severe bleeding problem during and after surgery. This test is making sure her red blood cells are adequate (no anemia is present), along with the 4 clotting tests on the bottom, starting with Prothrombin Time.
Our patient is now ready for gall bladder removal This is a specialized surgery that is tedious and requires an experienced surgeon. In Heather’s case we called in Dr. Linda Larsen, a specialist in surgery.
Dr. Larsen is a board certified surgeon, and experienced at this surgery
Monitoring of anesthesia is critical in an older pet with liver disease. Monitoring Heather’s blood pressure is an important aspect of anesthesia.
We keep a close tab on important physiologic parameters for all of our surgeries. Monitors like this give us an early warning of an impending problem.
Once our surgeon has scrubbed up and is in sterile gown, gloves, and mask, the surgery begins
The incision into the abdomen is made at a special location called the linea alba. It is here that the tendons of the stomach muscles come together, and will hold the sutures after we close the abdomen.
The swollen liver is apparent as soon as she enters the abdomen
The first thing our surgeon does is locate the gall bladder
Now the careful dissection of the gall bladder starts so it can be removed
After careful dissection it almost full exposed at this point
As dissection of the gall bladder continued she traced it down to the common bile duct. The arrow points to the gall bladder under our surgeon’s finger. The vertical bluish structure below the gall bladder is the enlarged common bile duct.
The bile that is stored in the gall bladder is removed with a suction apparatus. This allows better visualization.
When she is satisfied with the exposure she puts several very strong sutures where the gall bladder attaches to the liver
Here is the trouble maker after it has been removed
A biopsy is taken of the liver to give us substantial information as to its health
The abdomen is flushed many times to remove any contaminants
The long incision in the linea alba is sutured. After this layer, there are several more layers of sutures placed in the subcutaneous tissue and the skin.
At this point our patient is given a local anesthetic on the suture line, an additional pain injection, and the skin incision is treated with companion laser to decrease swelling and aid in healing,. You can its use on the video below.
This is a different gall bladder removed from a different patient. This gall bladder was thickened due to stones in it.
The inside of the gall bladder after removal. The chronic thickening is apparent.
These are the gall stones that were found inside of it
The pathology report on this gall bladder
This is the analysis of these stones
Our last page on Liver Disease goes over specific diseases: