Endovascular treatment of postoperative hemorrhage after pancreatectomy: a retrospective study.
Gastroduodenal artery bleeding
Pancreaticoduodenectomy
Pseudoaneurysm
Viabahn stent graft
Journal
BMC gastroenterology
ISSN: 1471-230X
Titre abrégé: BMC Gastroenterol
Pays: England
ID NLM: 100968547
Informations de publication
Date de publication:
07 Nov 2023
07 Nov 2023
Historique:
received:
16
05
2023
accepted:
30
10
2023
medline:
9
11
2023
pubmed:
8
11
2023
entrez:
7
11
2023
Statut:
epublish
Résumé
Ruptured aneurysm is a serious complication of distal pancreatectomy (DP) or pancreatoduodenectomy (PD) that can be life-threatening if not treated promptly. This study aimed to examine the efficacy of a Viabahn stent graft for stopping bleeding after pancreatectomy. Between April 2016 and June 2022, we performed 245 pancreatectomies in our institution. Six patients experienced postoperative bleeding and underwent endovascular treatment. All six cases of bleeding occurred post-PD (3.7%). The bleeding was from gastroduodenal artery (GDA) pseudoaneurysms in three patients, and Viabahn stent grafts were inserted. All three patients did not show liver function abnormalities or hepatic blood flow disorders. One patient with a Viabahn stent graft experienced rebleeding, which required further management to obtain hemostasis. Of the six cases in which there was hemorrhage, one case of bleeding from the native hepatic artery could not be managed. Using the Viabahn stent graft is an effective treatment option for postoperative bleeding from GDA pseudoaneurysms following PD. In most cases, using this device resulted in successful hemostasis, without observed abnormalities in hepatic function or blood flow.
Sections du résumé
BACKGROUND
BACKGROUND
Ruptured aneurysm is a serious complication of distal pancreatectomy (DP) or pancreatoduodenectomy (PD) that can be life-threatening if not treated promptly. This study aimed to examine the efficacy of a Viabahn stent graft for stopping bleeding after pancreatectomy.
METHODS
METHODS
Between April 2016 and June 2022, we performed 245 pancreatectomies in our institution. Six patients experienced postoperative bleeding and underwent endovascular treatment.
RESULTS
RESULTS
All six cases of bleeding occurred post-PD (3.7%). The bleeding was from gastroduodenal artery (GDA) pseudoaneurysms in three patients, and Viabahn stent grafts were inserted. All three patients did not show liver function abnormalities or hepatic blood flow disorders. One patient with a Viabahn stent graft experienced rebleeding, which required further management to obtain hemostasis. Of the six cases in which there was hemorrhage, one case of bleeding from the native hepatic artery could not be managed.
CONCLUSIONS
CONCLUSIONS
Using the Viabahn stent graft is an effective treatment option for postoperative bleeding from GDA pseudoaneurysms following PD. In most cases, using this device resulted in successful hemostasis, without observed abnormalities in hepatic function or blood flow.
Identifiants
pubmed: 37936060
doi: 10.1186/s12876-023-03022-9
pii: 10.1186/s12876-023-03022-9
pmc: PMC10631063
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
379Informations de copyright
© 2023. The Author(s).
Références
Arch Surg. 2008 Oct;143(10):1001-7; discussion 1007
pubmed: 18936380
Pancreas. 2015 Aug;44(6):953-8
pubmed: 25906453
Surgery. 2017 Mar;161(3):584-591
pubmed: 28040257
Dig Surg. 2018;35(1):19-27
pubmed: 28384642
Surg Today. 2001;31(10):932-5
pubmed: 11759894
J Vasc Interv Radiol. 2011 Mar;22(3):294-301
pubmed: 21353982
World J Surg. 2005 Sep;29(9):1122-6
pubmed: 16132400
Arch Surg. 2002 Jan;137(1):55-9
pubmed: 11772216
J Gastrointest Surg. 2011 Jun;15(6):1055-62
pubmed: 21267670
J Vasc Surg. 2016 Nov;64(5):1373-1383
pubmed: 27462001
J Gastrointest Surg. 2005 Dec;9(9):1293-9
pubmed: 16332485
J Am Coll Surg. 2005 Oct;201(4):554-9
pubmed: 16183493
Langenbecks Arch Surg. 2013 Mar;398(3):441-8
pubmed: 23435636
World J Surg Oncol. 2019 Jan 31;17(1):26
pubmed: 30704497
J Vasc Interv Radiol. 2014 Oct;25(10):1539-48
pubmed: 25149115
Hepatogastroenterology. 2003 Nov-Dec;50(54):2208-12
pubmed: 14696500
Biomed Res Int. 2016;2016:2815693
pubmed: 27975049
J Vasc Interv Radiol. 2016 Jan;27(1):73-9
pubmed: 26611883
Ann Surg. 1944 Jun;119(6):845-55
pubmed: 17858411
J Gastrointest Surg. 2014 Mar;18(3):464-75
pubmed: 24448997
Langenbecks Arch Surg. 2022 Aug;407(5):1949-1959
pubmed: 35306601
Surgery. 2007 Jul;142(1):20-5
pubmed: 17629996
Ann Surg Treat Res. 2019 May;96(5):237-249
pubmed: 31073514
J Am Coll Surg. 1998 Mar;186(3):325-30
pubmed: 9510264
Scand J Surg. 2017 Mar;106(1):47-53
pubmed: 26929287
Dig Surg. 2009;26(4):297-305
pubmed: 19602889
J Hepatobiliary Pancreat Sci. 2022 May;29(5):e41-e43
pubmed: 35064649
Br J Radiol. 2022 Oct 1;95(1139):20220022
pubmed: 36000821
ANZ J Surg. 2018 May;88(5):E435-E439
pubmed: 28480620
Abdom Radiol (NY). 2020 Oct;45(10):3337-3341
pubmed: 32095858
Surg Today. 2021 Jul;51(7):1232-1236
pubmed: 32979122
Abdom Radiol (NY). 2021 Oct;46(10):4995-5006
pubmed: 34037809