Gastrointestinal Bleed After Total Pancreatectomy With Islet Autotransplant.
Adult
Female
Gastrointestinal Hemorrhage
/ diagnosis
Humans
Islets of Langerhans Transplantation
/ adverse effects
Male
Middle Aged
Pancreatectomy
/ adverse effects
Postoperative Complications
/ diagnosis
Prospective Studies
Retrospective Studies
Risk Assessment
/ methods
Risk Factors
Transplantation, Autologous
Young Adult
Journal
Pancreas
ISSN: 1536-4828
Titre abrégé: Pancreas
Pays: United States
ID NLM: 8608542
Informations de publication
Date de publication:
01 07 2021
01 07 2021
Historique:
pubmed:
5
8
2021
medline:
8
2
2022
entrez:
4
8
2021
Statut:
ppublish
Résumé
Gastrointestinal bleeding (GIB) is an uncommon complication after abdominal surgery. Given the unique risks in the total pancreatectomy with islet autotransplant (TPIAT) population, we aimed to describe this population's incidence of postoperative GIB. Prospectively collected data on patients who underwent a TPIAT from 2001 to 2018 at the University of Minnesota were reviewed for postoperative GIB. Each GIB patient was matched to a control patient and compared for medical, medication, and social history and for clinical outcomes. Sixty-eight patients developed a GIB (12.4%) at median time after surgery of 17 months. Etiologies included the following: anastomotic ulcer (35%), Clostridium difficile (4%), gastric or duodenal ulcers (9%), esophagitis/gastritis (10%), hemorrhoids (3%), inflammatory bowel disease (4%), Mallory-Weiss tears (1%), and unknown (29%). During diagnostic workup, 87% had an endoscopic procedure and 3% underwent imaging. Seven patients required an operation (10%), 1 required an open embolization (1%), and 13 required endoscopic treatments (19%). Patients with a GIB were more likely to die (15% vs 5%, P = 0.055). Twelve percent of patients developed a GIB after TPIAT. One third of those had an undefined etiology despite endoscopy. The need for intervention was high (30%).
Identifiants
pubmed: 34347732
doi: 10.1097/MPA.0000000000001842
pii: 00006676-202107000-00010
pmc: PMC8373743
mid: NIHMS1713623
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
841-846Subventions
Organisme : NIDDK NIH HHS
ID : T32 DK108733
Pays : United States
Informations de copyright
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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