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[Delayed massive hemorrhage after pancreaticoduodenectomy]
Xiang-fei Meng1, Jing Wang, Zhi-jun Wang
1Department of Hepatobiliary Surgery, PLA General Hospital, Beijing 100853 China.
Zhonghua Yi Xue Za Zhi
|July 12, 2012
Summary
Delayed massive hemorrhage (DMH) is a rare, fatal complication after pancreaticoduodenectomy (PD). Sentinel bleeding predicts DMH, and interventional arteriography aids diagnosis and treatment, though mortality remains high.
Area of Science:
- Gastroenterology and Hepatology
- Surgical Oncology
- Vascular Surgery
Context:
- Delayed massive hemorrhage (DMH) is a rare but life-threatening complication following pancreaticoduodenectomy (PD).
- Understanding the risk factors and treatment outcomes for DMH is crucial for improving patient survival rates.
- This study reviews clinical experiences with DMH after PD to identify key management strategies.
Purpose:
- To summarize clinical experiences with delayed massive hemorrhage (DMH) after pancreaticoduodenectomy (PD).
- To evaluate risk factors associated with DMH post-PD.
- To compare the efficacy of different therapeutic interventions for DMH.
Summary:
- A retrospective analysis of 1008 PD patients identified 14 cases (1.4%) of DMH.
- Pancreatic fistula (71.4%) and sentinel bleeding (71.4%) were common complications/predictors.
- Interventional therapy and surgery were employed, with a high overall mortality rate of 71.4%.
Impact:
- DMH is a challenging complication of PD with significant mortality.
- Sentinel bleeding is a valuable predictor of DMH.
- Interventional arteriography offers effective diagnostic and therapeutic benefits for managing DMH.
