Cellophane Banding Without Intraoperative Attenuation of Congenital Gastrophrenic Shunts in 12 Cases

Abstract

Reports on patients with a gastrophrenic shunt treated with cellophane banding without attenuation are scarce. This case series evaluated the outcomes of cellophane banding without intraoperative attenuation in patients with a congenital left gastrophrenic shunt. Seven client-owned dogs and five client-owned cats with congenital left gastrophrenic shunt were included. Data collected from the medical records included signalment, history, physical examination, clinicopathologic testing, diagnostic imaging (pre and postoperative), perioperative complications, hepatic histopathological evaluation, and clinical outcomes. The application of a cellophane band without intraoperative attenuation of congenital left gastrophrenic shunts resulted in complete closure in 10/11 patients at a median follow-up of 60 days (range: 33–174) based on ultrasound. The mean shunt diameter was 6.1 mm (range: 4.2–8). One dog had partial closure of the shunt at 3 months but was lost to follow-up. One dog died perioperatively from seizures. One cat experienced post-attenuation neurologic signs that completely resolved. Cellophane banding without intraoperative attenuation appeared to be a safe and potentially effective approach for managing gastrophrenic shunts. The percentage of shunt closure observed in this cases series is higher than that historically reported for other shunt localizations. Shunt localization may influence closure. Residual shunting may not be associated with shunt diameter. Further studies with larger sample sizes and standardized follow-ups are needed to confirm its efficacy.

Keywords

• portosystemic shunt
• gastrophrenic shunt
• cellophane band attenuation
• surgery
• small animals