LONG-TERM RESULTS OF COMPLETE AND PARTIAL LIGATION OF CONGENITAL PORTOSYSTEMIC SHUNTS IN DOGS

The medical records of 65 dogs that underwent complete or partial liga tion of a single congenital portosystemic shunt (CPSS) were reviewed t o determine the long-term clinical results. Information retrieved from the records included age at surgery, preligation (baseline) portal pr essure, postligation portal pressure, change in portal pressure from b aseline, complete or partial occlusion of the shunting vessel and fast ing, and 2-hour postprandial bile acids from the preoperative, early p ostoperative (PO), and greater than 1 year PO time periods. A clinical rating score derived from a follow-up examination greater than 1 year PO was assigned to each dog. Of the 56 dogs that survived the periope rative period, 29 (52%) had complete and 27 (48%) had partial ligation s. Age at surgery, pre- and postligation portal pressure, change in po rtal pressure from baseline and serum bile acid concentrations were no t related to long-term clinical outcome. Clinical rating scores were s ignificantly greater for dogs with partial CPSS ligations compared wit h dogs with complete ligations, indicating a less favorable clinical o utcome for partial ligations. Fasting and 2-hour postprandial bile aci d values at both PO time intervals were significantly greater in parti al versus complete ligation groups. Follow-up information for more tha n 1 year was available on 18 of 29 dogs (62%) with complete ligations. All were clinically normal. Of 27 dogs with partial ligations, 11 dog s (41%) developed recurrence of clinical signs resulting in presentati on to the university or referring veterinarian for additional surgery, medical management, or euthanasia. Only three dogs with partial CPSS ligation (11%) were clinically normal. Another nine dogs (33%) were op erated on again before the possible development of clinical signs and four dogs (15%) were unavailable for follow-up. It was concluded that partial ligation of CPSS is associated with a greater recurrance of cl inical signs and patient morbidity than complete ligation. (C)Copyrigh t 1995 by The American College of Veterinary Surgeons