Interventional therapy of late hemorrhage after postpancreatectomy / 中国介入影像与治疗学

ABSTRACT

Objective: To observe the effect of interventional therapy for late hemorrhage after postpancreatectomy. Methods: Totally 50 patients with late hemorrhage after postpancreatectomy were retrospectively analyzed. Among 50 patients, 42 underwent transcatheter arterial angiographies, and then 28 of them underwent only interventional therapy, while 14 were converted to surgical treatment after interventional therapy. Direct surgical exploration was performed in the rest 8 cases. The angiographic features and responsible vessels for bleeding were observed, and perioperative results were recorded. Results: For all 50 patients, stop bleeding rate was 66.00% (33/50), and the mortality rate was 34.00% (17/50), while for pure interventional therapy, stop bleeding rate was was 82.14% (23/28) and the death rate was 17.86% (5/28). Among 42 patients underwent angiography, positive findings were observed in 26 patients, pseudoaneurysm was the most common bleeding sign (46.15% [12/26]), and hepatic intrinsic/common artery were the most involved vessels (53.85% [14/26]). Among 26 cases with positive angiography, 24 underwent embolization based on coils, including 8 with coils only, 12 with coils combined with gelatin sponge particles and 4 with coils combined with PVA particles, while 2 cases were treated with covered stents implantation of hepatic artery. Conclusion: Interventional therapy is effective for treatment of late hemorrhage after postpancreatectomy.