Liver biopsy techniques for adult horses and neonatal foals to assess copper status

Objective To evaluate standing, percutaneous, ultrasound-guided, transthoracic liver biopsy in mares, and transabdominal, laparoscopically-guided, liver biopsy under general anaesthesia in foals, as techniques for obtaining tissue for assessment of copper status. The techniques were evaluated with respect to ease of use and effect on the animal.
Procedure Twenty of 24 Thoroughbred mares and 21 of their foals were biopsied. The animals were part of a larger study of the effect of copper supplementation on copper status and the prevalence of developmental orthopaedic disease. Livers were also collected from unrelated horses and sampled to investigate the variability in the distribution of copper in liver tissue.
Result The biopsy technique caused no lasting effect on the mares, but there was an increased risk of viscus penetration associated with taking multiple biopsy cores. The use of ultrasonography to scan the target area for the liver identified four cases that were not appropriate candidates for liver biopsy, because of large intestine being located in the biopsy area. In the foals there were no serious postoperative adverse effects, nor was there any evidence of problems caused by the procedure when the abdomen was examined post-mortem at 5 months of age. In livers collected to investigate the variability of copper concentration, copper appeared to be relatively evenly distributed through the liver.
Conclusion Standing, percutaneous, ultrasound-guided, transthoracic liver biopsy in mares, and transabdominal, laparoscopically-guided, liver biopsy under general anaesthesia in foals are convenient procedures for obtaining liver tissue for assessing copper status in horses. The use of ultrasound to identify liver tissue is recommended, especially in older mares.     

Laparoscopic nephron-sparing surgery for the treatment of canine dioctophymosis

This paper reports on two cases of laparoscopic nephrotomy employed in the treatment of canine dioctophymosis, which is considered a unusual procedure and a new treatment proposal heretofore not performed in veterinary medicine. Two patients were treated, one with a history of hematuria and the other with incidental finding of the parasite in the abdominal cavity during elective ovariohysterectomy. Both dogs were subjected to abdominal ultrasound, which produced images indicating the presence of the parasite in the right side kidney, but with partial parenchymal preservation. The patients were therefore subjected to laparoscopic nephrotomy. The surgical procedure was effective in treating dioctophymosis and enabled minimum tissue invasion during surgery, in addition to preservation of the kidney.     

Pancreatic adenocarcinoma in a donkey. Use of laparoscopy to aid the diagnosis

Pancreatic adenocarcinoma was diagnosed in a 15‐year‐old donkey that presented with signs of chronic laminitis, weight loss and chronic colic. An intra‐abdominal mass was identified by exploratory laparoscopy, and this was subsequently confirmed to be a pancreatic adenocarcinoma at post mortem examination. Unlike most previously reported cases of pancreatic disease in equids, this donkey had no clinicopathological evidence of an associated hepatopathy.     

Laparoscopically‐assisted ovariohysterectomy in three mares with pyometra

Open surgical ovariohysterectomy in the mare provides limited visualisation and a long surgical incision. Laparoscopically‐assisted ovariohysterectomy has been performed by the authors in 3 mares with pyometra. This approach does seem to offset some of these disadvantages.     

困难型腹腔镜胆囊切除术的困难原因及处理

目的 :探讨困难型腹腔镜胆囊切除术的困难原因及术中的处理技巧。方法 :回顾性分析 1 0 5例困难型腹腔镜胆囊切除术的临床资料。结果 :困难原因分别为 Calot三角区粘连 89例 (占 84 .6 % ,与以下各原因比较 P<0 .0 5 ) ,胆囊与邻近脏器粘连 2 7例 (占 2 5 .7% ) ,胆囊颈部嵌顿结石 2 0例 (占 1 9.1 % ) ,胆囊肿大 2 3例 (占 2 1 .9% ) ,胆囊炎症充血、水肿、壁增厚≥ 0 .6 cm 1 8例 (占 1 7.1 % ) ,胆囊萎缩 34例 (占 32 .4 % ) ,肝外胆管变异 2 1例 (占 2 0 % ) ,血管变异 2 6例 (占2 4 .8% ) ;其中有 86 .7%的病例合并两种以上的困难原因。成功 1 0 1例 ,成功率 96 .2 % ,无胆管损伤、死亡病例。结论 :Calot三角区粘连为常见困难原因 ;Calot三角区粘连处理直接影响手术成功率和并发症发生     

腹腔镜胆囊切除术及其并发症的预防（附30例报告）

用腹腔镜行胆囊切除术３０例。术前均经Ｂ超检查确诊为胆囊结石者２４例和胆囊息肉６例。３０例中有２９例获手术成功，１例因胆囊萎缩在术中转为开腹术，出现并发症者４例，其中１例因胆素床出血转为开腹后发现出血已停，另３例术后出现皮下气肿。手术时间最短１５ｍｉｎ，最长８７ｍｉｎ，平均２８ｍｉｎ。住院时间最短４天，最长１１天，平均６．５天。     

腹腔镜下输卵管切除术对卵巢功能的近期影响

目的：探讨腹腔镜下输卵管切除术对卵巢功能的近期影响。方法：将60例拟行输卵管切除术的异位妊娠患者随机分为3组（n=20）．手术方式分别采用腹腔镜单极电凝．腹腔镜双极电凝和开腹手术。术后1月、3月检测血清E2、P、T、FSH和LH水平，并与20例健康志愿者的激素水平相比较，观察患者术后月经恢复情况。结果：3组病人手术后卵巢激素水平与健康志愿者无显著差异，各组之间亦无显著差异，术后月经恢复情况各组之间也无明显差异。结论：与开腹手术一样．腹腔镜输卵管切除术对卵巢功能无明显影响。     

腹腔镜全膀胱切除原位W形回肠代膀胱术的疗效评价

目的总结腹腔镜全膀胱切除原位W形回肠代膀胱术的疗效。方法 11例浸润性膀胱癌患者行腹腔镜下全膀胱切除加原位W形回肠代膀胱术,记录手术时间、出血量、术后控尿功能恢复时间等。结果平均手术时间及出血量分别为7.5±0.8 h、610.3±12.5 m L,术后30~42 d均恢复控尿功能。术后21 d静脉尿路造影未见输尿管返流及梗阻。术后3个月尿动力检查显示尿流曲线呈持续型8例,间歇型3例。结论腹腔镜膀胱全切除原位W形回肠代膀胱术安全可行,控尿效果良好。