Pancreaticoduodenectomy with choledochoduodenostomy and pancreaticojejunostomy in a cat with bile and pancreatic duct obstruction secondary to a recurrent carcinoid.

Abstract

OBJECTIVE: To describe the surgical procedure for pancreaticoduodenectomy with choledochoduodenostomy and pancreaticojejunostomy for carcinoids of the common bile duct (CBD) in a cat and to report its outcomes. STUDY DESIGN: Case report. ANIMAL: A 6-year-old neutered male Munchkin cat. METHODS: A small tissue plug causing CBD obstruction was surgically removed from a cat. The obstructive plug was diagnosed histopathologically as carcinoid. Nine months after initial surgery, the cat developed anorexia and vomiting. Diagnostic imaging revealed dilation of both the CBD and pancreatic duct, and the cat underwent a second surgery 11 months after the initial procedure. En bloc resection of the pancreatic body and duodenum, including the site of the CBD obstruction, was performed. Following the duodenal reconstruction with end-to-end anastomosis, the biliary system was rebuilt with end-to-side anastomosis, connecting the CBD's resected end to the duodenum. Pancreatojejunostomy of the distal end of the left pancreatic lobe and jejunum was performed to reconstruct the pancreatic duct. RESULTS: No postoperative complications such as bile leakage, pancreatic fluid leakage, or pancreatitis were observed. Toceranib therapy was initiated postoperatively. The cat showed good general condition 524 days after the second surgery and exhibited favorable progress at the time of writing. CONCLUSION: This is the first report of a successful reconstructive surgery with choledochoduodenostomy and pancreatojejunostomy after en bloc resection of the pancreatic body and proximal duodenum in a cat with recurrent carcinoid-induced ductal obstruction. Pancreatic body duodenectomy may be a viable and effective option for managing pancreatic duct obstruction in cats.