Application of Billroth II gastrojejunostomy and a biliary stent in a dog with gastric adenocarcinoma and the associated extrahepatic biliary obstruction

Authors: DA EUN LEE, HA EUN LEE, SOON WUK JEONG, HUN YOUNG YOON

Abstract: An 11-year-old intact female chow chow dog was presented for evaluation of intermittent vomiting and anorexia for a month. On ultrasonographic examination, gastric pylorus hypertrophy which compressed common bile duct was identified. The gallbladder was significantly enlarged and mucocele was suspected. Cholecystectomy and gastric full thickness biopsy were performed and gastric adenocarcinoma was diagnosed by histopathological examination. Billroth II gastrojejunostomy using thoracoabdominal-stapler (TAstapler) was performed. On surgery, hypertrophied tissue suspected of tumour was also found adjacent to the major duodenal papilla. After surgery, vomiting disappeared, and the patient regained appetite. On postoperative day 90, the patient was presented vomiting and jaundice again. On ultrasonography, the common bile duct was dilated and a narrowing of diameter was identified adjacent to major duodenal papilla. Biliary stenting with double wired nitinol uncovered stents was performed. On abdominal radiography, the diameter of bile duct stricture region was increased 7 days postoperatively. The patient had no complications related to biliary stent and died of gastric adenocarcinoma 1 year postoperatively.

Keywords: Billroth II gastrojejunostomy, double wired nitinol biliary stent, malignant extrahepatic biliary obstruction, gastric adenocarcinoma, dog

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