Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
3318124 | Pancreatology | 2011 | 9 Pages |
Abstract
Objective: To investigate the diagnosis and treatment of delayed post-pancreaticoduodenectomy arterial bleeding (DPPAB). Methods: Records of 336 patients who underwent pancreaticoduodenectomy (PD) between January 2000 and December 2010 were retrospectively analyzed. Detailed data of patients with DPPAB were assessed by a thorough review of medical records. Results: 14 patients developed DPPAB. The mean time interval between the initial surgery and DPPAB was 33 days (range 7-72). Three patients experienced sentinel bleeding 5-8 days before DPPAB. All DPPAB patients had intra-abdominal septic complications before bleeding. The overall prevalence of success of angiography and transcatheter arterial embolization (TAE) was 85.7% (12/14), including 3 patients who achieved complete hemostasis by TAE after unsuccessful re-laparotomy. The prevalence of mortality of DPPAB was 28.6% (4/14). After hemostasis was achieved, intra-abdominal septic complications were controlled by percutaneous catheter drainage or re-laparotomy with drain replacement. Conclusion: Angiography and TAE are recommended as the first-line diagnostic and treatment choice for DPPAB, respectively. Surgical intervention should be preserved to eliminate the cause of bleeding.
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Authors
Ji Zhang, Xu Zhu, Hui Chen, Hong-Gang Qian, Jia-Hua Leng, Hui Qiu, Jian-Hui Wu, Bo-Nan Liu, Qiao Liu, Ang Lv, Ying-Jie Li, Guo-Quan Zhou, Chun-Yi Hao,