{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:58:28Z","timestamp":1785419908205,"version":"3.56.0"},"reference-count":20,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002583","name":"Gyeongsang National University","doi-asserted-by":"publisher","award":["GNU-NFRSG-0018"],"award-info":[{"award-number":["GNU-NFRSG-0018"]}],"id":[{"id":"10.13039\/501100002583","id-type":"DOI","asserted-by":"publisher"}]},{"award":["GNU-NFRSG-0018"],"award-info":[{"award-number":["GNU-NFRSG-0018"]}],"id":[{"id":"https:\/\/ror.org\/00saywf64","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Veterinary Sciences"],"abstract":"<jats:p>The middle hepatic vein (MHV) may lie in close proximity to the gallbladder fossa and represent a potential source of severe hemorrhage during cholecystectomy. While this anatomical relationship is well recognized in human surgery, the clinical relevance of MHV proximity during canine cholecystectomy has rarely been described. Two dogs underwent cholecystectomy for gallbladder disease. In Case 1, an 8-year-old Pomeranian with gallbladder mucocele and necrotizing cholecystitis developed sudden massive hemorrhage during dissection of the gallbladder from the hepatic fossa between the quadrate and right medial liver lobes, when a branch of the middle hepatic vein (MHV) adherent to the gallbladder wall ruptured, causing rapid hypotension (mean arterial pressure 10\u201320 mmHg). Hemostasis was achieved using hemoclips, and the dog recovered following transfusion. In Case 2, an 11-year-old Spitz with a gallbladder mass underwent cholecystectomy and liver biopsy. Preoperative computed tomography demonstrated MHV branches coursing within &lt;1 mm of the gallbladder wall. Careful dissection preserved the venous structures, and surgery was completed without significant hemorrhage. MHV branches may occur immediately adjacent to the gallbladder fossa in dogs and may represent an underrecognized source of hemorrhage during cholecystectomy. Awareness of this relationship and preoperative vascular evaluation in selected cases may improve surgical safety.<\/jats:p>","DOI":"10.3390\/vetsci13070680","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:34:44Z","timestamp":1783996484000},"page":"680","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical Significance of Middle Hepatic Vein Proximity to the Gallbladder Fossa During Canine Cholecystectomy in Two Dogs"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7531-9147","authenticated-orcid":false,"given":"Sin-Yeong","family":"Park","sequence":"first","affiliation":[{"name":"Department of Veterinary Surgery, College of Veterinary Medicine, Gyeongsang National University, 501, Jinjudae-ro, Jinju 52828, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youjung","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ulsan S Animal Medical Center, Ulsan 44726, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2645-4508","authenticated-orcid":false,"given":"Dongbin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Veterinary Surgery, College of Veterinary Medicine, Gyeongsang National University, 501, Jinjudae-ro, Jinju 52828, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3530-9860","authenticated-orcid":false,"given":"Chang-Hwan","family":"Moon","sequence":"additional","affiliation":[{"name":"Department of Veterinary Surgery, College of Veterinary Medicine, Gyeongsang National University, 501, Jinjudae-ro, Jinju 52828, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.2460\/javma.229.9.1451","article-title":"Long-term survival and risk factors associated with biliary surgery in dogs: 34 cases (1994\u20132004)","volume":"229","author":"Amsellem","year":"2006","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"970","DOI":"10.2460\/javma.252.8.970","article-title":"Outcome of elective cholecystectomy for the treatment of gallbladder disease in dogs","volume":"252","author":"Youn","year":"2018","journal-title":"J. Am. Vet. Med. Assoc."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1111\/vsu.14189","article-title":"Clinical findings and prognostic factors for immediate survival in 33 dogs undergoing surgery for biliary peritonitis","volume":"54","author":"Renaud","year":"2025","journal-title":"Vet. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1111\/vec.12910","article-title":"Prevalence and impact of cholecystitis on outcome in dogs with gallbladder mucocele","volume":"30","author":"Rogers","year":"2020","journal-title":"J. Vet. Emerg. Crit. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1111\/jsap.13312","article-title":"Clinical findings for dogs undergoing elective and nonelective cholecystectomies for gall bladder mucoceles","volume":"62","author":"Friesen","year":"2021","journal-title":"J. Small Anim. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1111\/vsu.13542","article-title":"Association between biliary tree manipulation and outcome in dogs undergoing cholecystectomy for gallbladder mucocele: A multi-institutional retrospective study","volume":"50","author":"Piegols","year":"2021","journal-title":"Vet. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"O49","DOI":"10.1111\/vsu.12534","article-title":"Perioperative complications and outcome of laparoscopic cholecystectomy in 20 dogs","volume":"45","author":"Scott","year":"2016","journal-title":"Vet. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"O150","DOI":"10.1111\/vsu.13731","article-title":"Intraoperative cholangiography and bile duct flushing in 47 dogs receiving laparoscopic cholecystectomy for benign gallbladder disease: A retrospective analysis","volume":"51","author":"Kanai","year":"2022","journal-title":"Vet. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1007\/s004640000358","article-title":"The influence of intraoperative complications on adhesion formation during laparoscopic and conventional cholecystectomy in an animal model","volume":"15","author":"Gamal","year":"2001","journal-title":"Surg. Endosc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5603\/FM.2014.0071","article-title":"Corrosion cast study of the canine hepatic veins","volume":"73","author":"Vrecl","year":"2014","journal-title":"Folia Morphol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1292\/jvms.14-0469","article-title":"Anatomical evaluation of hepatic vascular system in healthy beagles using X-ray contrast computed tomography","volume":"77","author":"Oishi","year":"2015","journal-title":"J. Vet. Med. Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.1055\/s-0040-1701695","article-title":"Management of middle hepatic vein injury during laparoscopic cholecystectomy: A case report","volume":"6","author":"Cadena","year":"2020","journal-title":"Surg. J."},{"key":"ref_13","first-page":"49","article-title":"A serious danger in laparoscopic cholecystectomy: Middle hepatic vein (Careful for serious bleeding)","volume":"29","author":"Kaya","year":"2022","journal-title":"Laparosc. Endosc. Surg. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1007\/s00276-017-1845-8","article-title":"Unexpected bleeding during laparoscopic cholecystectomy: A hepatic vein injury","volume":"39","author":"Eugeni","year":"2017","journal-title":"Surg. Radiol. Anat."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Chae, H.K., Jeong, J.Y., Lee, S.Y., Hwang, H.M., Shin, K.I., Park, J.H., Ji, S.Y., and Hong, Y.J. (2023). Clinical outcomes in dogs undergoing cholecystectomy via a transverse incision: A meta-analysis of 121 animals treated between 2011 and 2021. Vet. Sci., 10.","DOI":"10.3390\/vetsci10060395"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"338","DOI":"10.4240\/wjgs.v15.i3.338","article-title":"Vascular injury during laparoscopic cholecystectomy: An often-overlooked complication","volume":"15","author":"Pesce","year":"2023","journal-title":"World J. Gastrointest. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/S0002-9610(99)00202-0","article-title":"Ultrasonographic assessment of the risk of injury to branches of the middle hepatic vein during laparoscopic cholecystectomy","volume":"178","author":"Misawa","year":"1999","journal-title":"Am. J. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"425","DOI":"10.4097\/kjae.2014.67.6.425","article-title":"Paradoxical carbon dioxide embolism during laparoscopic cholecystectomy as a cause of cardiac arrest and neurologic sequelae: A case report","volume":"67","author":"Shin","year":"2014","journal-title":"Korean J. Anesthesiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1148\/rg.245035224","article-title":"Preoperative hepatic vascular evaluation with CT and MR angiography: Implications for surgery","volume":"24","author":"Sahani","year":"2004","journal-title":"Radiographics"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1148\/rg.282075099","article-title":"Vascular and biliary variants in the liver: Implications for liver surgery","volume":"28","author":"Catalano","year":"2008","journal-title":"Radiographics"}],"container-title":["Veterinary Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2306-7381\/13\/7\/680\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T03:11:50Z","timestamp":1783998710000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2306-7381\/13\/7\/680"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,13]]},"references-count":20,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["vetsci13070680"],"URL":"https:\/\/doi.org\/10.3390\/vetsci13070680","relation":{},"ISSN":["2306-7381"],"issn-type":[{"value":"2306-7381","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,13]]}}}