[Transcatheter arterial embolization for massive abdominal bleeding in post-pancreatoduodenectomy--first report]

Transcatheter arteria embolization (TAE) was carried out for 10 cases (14 times) with massive intra-abdominal bleeding after pancreatoduodenectomy (PD). The results obtained were as follows: 1. The ten patients (carcinoma of the pancreas head 4, carcinoma of the papilla Vater: 3, carcinoma of the bile duct: 2. leiomyosarcoma of the duodenum: 1) included eight men and two women aged 45 to 75, with an average age of 63.7. The time span before TAE was instituted averaged 20.8 days. 2. Infection due to leakage noted in all cases. 3. A good course was noted when manifestation of symptoms related to poor sutures or the onset of intra-abdominal bleeding after PD was delayed and the time from the onset of intra-abdominal bleeding to TAE was short. 4. Bleeding sites could be determined in all cases. Pseudoaneurysm accounted for five and extravasation accounted for nine of the total of 14 bleeding sites. The prognosis was apparently good in cases of pseudoaneurysm as compared with that in cases of extravasation. 5. Bleeding was controlled in all cases. 6. No complication due to TAE occurred. These results indicate the TAE is a safe and effective procedure for the control of massive intra-abdominal bleeding after PD.