Laparoscopic cholecystectomy in the dog

Laparoscopic cholecystectomy is a routine and common procedure in human medical practice and is the treatment of choice for gallstone disease and acute cholecystitis, as it has been shown to be less invasive and safer than traditional open surgical methods (Barkun et al, 1992; Hendolin et al, 2000). It is a much less common procedure in veterinary medicine, where gall bladder disease is less common. When cholecystectomy is indicated in veterinary medicine, open procedures by laparotomy are usually performed. Indications for cholecystectomy in dogs and cats include necrotising cholecystitis, gall bladder trauma or neoplasia, symptomatic cholelithiasis and gall bladder mucocoele. Of these, uncomplicated gall bladder mucocoeles are most common and are probably the most suitable for treatment with laparoscopic cholecystectomy (Lhermette et al, 2020). Gall bladder mucocoeles are more common in older dogs and certain breeds have a predisposition, in particular the Border Terrier, the miniature Schnauzer, Shetland Sheepdog and Cocker Spaniels. There does not appear to be any sex predilection, but there is a strong association with Cushing's disease which increases the risk of mucocoele development 29-fold in susceptible breeds (Mesich et al, 2009). Exogenous administration of corticosteroids can also increase the risk, as can dyslipidaemia, although the underlying cause is not yet fully understood. Biliary sludge is a common and incidental finding in dogs and can make diagnosis of early cases of mucocoele difficult on ultrasound examination (Figure 1).