Bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Vascular Surgery

Background:

• Spontaneous hemorrhage is a serious complication of chronic pancreatitis.
• Pseudocysts are the most common cause of bleeding in these patients.

Purpose of the Study:

• To investigate the causes and management of spontaneous hemorrhage in chronic pancreatitis patients.
• To evaluate the outcomes of different surgical strategies for bleeding pseudocysts and pseudoaneurysms.

Main Methods:

• Retrospective analysis of 17 patients with spontaneous hemorrhage related to chronic pancreatitis.
• Review of patient data including etiology, bleeding source, management strategies, and outcomes.
• Comparison of outcomes between primary pancreatic resection and other interventions like vessel ligation.

Main Results:

• Pseudocysts accounted for 88% of hemorrhages, with arterial erosion occurring in four patients.
• Primary pancreatic resection in 10 patients resulted in no mortality but four early complications.
• Transcystic ligation in five patients led to complications, including one death from sepsis and liver failure, and reoperations.

Conclusions:

• Primary pancreatic resection, despite technical challenges, is the preferred treatment for bleeding pseudocysts and pseudoaneurysms in chronic pancreatitis.
• Management strategies focused on bleeding control and pancreatic segment removal yield favorable results.
• Prompt surgical intervention is crucial, with higher mortality associated with emergency surgery.