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01-08-2011 | Original Article

Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery

Authors: Xiangjiu Ding, Jiankang Zhu, Min Zhu, Caixia Li, Wencheng Jian, Jianjun Jiang, Zhanmin Wang, Sanyuan Hu, Xusheng Jiang

Published in: Journal of Gastrointestinal Surgery | Issue 8/2011

Abstract

Introduction

Hemorrhage from pseudoaneurysms after pancreatic surgery is a rare but life-threatening and complicated complication. The study presents our experience to provide therapeutic management for this rare condition.

Methods

Between February 1994 and January 2011, 35 patients experienced hemorrhage from pseudoaneurysms in our hospital. Medical data of this rare complication were analyzed retrospectively.

Results

The prevalence of hemorrhage from pseudoaneurysms was 3.2% (35/1,102). Sixteen patients (45.7%) experienced sentinel bleeding. Pancreatic fistula (74.3%) and intra-abdominal abscess (57.1%) were two common complications prior to hemorrhage. Of 35 patients, 20 underwent endovascular intervention, 14 received surgical re-laparotomy, and bleeding stopped spontaneously in one. The overall mortality rate was 22.9%. Technical success rate of endovascular treatment was 87%. There were significant differences in the mortality rate (10.0% vs 42.9%), operation time (72.8 vs 123.9 min), estimated blood loss (1,835 vs 3,000 ml), and intensive care unit stay (3.6 vs 8.6 days) between endovascular and surgical treatment. Mean follow-up was 19.2 ± 17.0 (range, 5–63 months).

Conclusion

Endovascular intervention represents the first-line treatment for hemorrhage from pseudoaneurysms after pancreatic surgery. Endovascular embolization or stent-graft placement should be selected individually depending on the involved artery and its vascular anatomy.

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Title: Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery
Authors: Xiangjiu Ding
Jiankang Zhu
Min Zhu
Caixia Li
Wencheng Jian
Jianjun Jiang
Zhanmin Wang
Sanyuan Hu
Xusheng Jiang
Publication date: 01-08-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 8/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1561-3

At a glance: The STEP trials

Springer Medicine

Therapeutic Management of Hemorrhage from Visceral Artery Pseudoaneurysms after Pancreatic Surgery

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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