Clinical findings and prognostic factors for immediate survival in 33 dogs undergoing surgery for biliary peritonitis

Solène Renaud DVM, Mila Freire DMV, PhD, DACVS (Small Animal), Elizabeth O'Toole BSc, DVM, DVSc, DACVECC, Louis Huneault DMV, MSc, DACVS (Small Animal), Marie Llido DVM, Brendon Ringwood DMV, MSc, DACVS, Tristan Juette PhD, Dominique Gagnon DMV, DVSc, DACVS (Small Animal)

Background:
Biliary peritonitis in dogs, caused by bile leakage into the abdomen, is a severe condition often requiring surgical intervention. While surgery improves outcomes, the associated mortality remains high, and there is limited data on factors influencing survival.

Methods:
This retrospective, multi-institutional cohort study analyzed the medical records of 33 dogs treated surgically for biliary peritonitis between 2015 and 2021. Data included demographics, clinical signs, diagnostic test results, surgical findings, and perioperative care. Statistical analyses identified prognostic factors affecting immediate postoperative survival.

Results:
Cholecystectomy was the most common surgery (94%). The in-hospital mortality rate was 36%. Key prognostic factors for reduced survival included preoperative hyperbilirubinemia (threshold: >60.5 µmol/L), use of vasopressors, renal dysfunction, and the number of postoperative complications. No significant survival difference was observed between septic and nonseptic biliary peritonitis cases.

Limitations:
The small sample size (33 dogs) limits the statistical power and generalizability. Additionally, variability in diagnostic and treatment protocols across institutions may affect outcomes.

Conclusions:
Hyperbilirubinemia, vasopressor use, renal dysfunction, and postoperative complications were significant predictors of mortality. The findings underscore the need for early intervention and careful perioperative management to improve survival rates. Further research with larger sample sizes is warranted.

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