Clinical studySuperselective Embolization for the Management of Postpancreatectomy Hemorrhage: A Single-Center Experience in 25 Patients
Section snippets
Patients
Data were obtained from a prospective clinical database and reviewed for patients undergoing angiography for suspected late PPH between January 2002 and July 2010. Institutional review board approval was obtained for this retrospective study. Hemorrhage was suspected when one or more of the following signs were observed: fresh blood loss through abdominal drains or nasogastric tubes, hematemesis or melena, unexplained hypotension or tachycardia, or decrease in hemoglobin (9).
Postoperative late
Patients
Between January 2002 and July 2010, 4,295 patients underwent pancreatic surgery at our hospital. Of these patients, 25 (19 males) were scheduled for emergency embolization for suspected late PPH 33.3 days ± 55.8 after surgery (range 5–292 days, median 22 days). Mean age of patients was 59 years ± 11 (range 29–73 years, median 62 years). Surgical procedures are shown in the Table. Six (24%) patients had suspected sentinel bleeding. Mean initial hemoglobin value was 7.2 g/dL (range 3.0–10.3
Discussion
Pseudoaneurysms are a common finding in patients with late hemorrhage after pancreatic surgery (18). In our study, pseudoaneurysms caused arterial hemorrhage in 7 (30%) patients. Most cases originated from the hepatic artery. Frequently, sentinel bleeding precedes massive hemorrhage. In a study by de Castro et al (12), 78% of patients showed sentinel bleeding within a mean postoperative interval of 17.6 days. Tien et al (10) observed sentinel bleeding in 20 (7%) of 283 patients undergoing
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None of the authors have identified a conflict of interest.