Hemorrhage Following Pancreatoduodenectomy
Journal of the Korean Surgical Society
;
: 157-161, 2002.
Artigo
em Coreano
| WPRIM
| ID: wpr-41884
ABSTRACT
PURPOSE:
Hemorrhage following pancreatoduodenectomy is a severe, life-threatening complication. This study was conducted to suggest methods of the prevention and management of hemorrhagic complications.METHODS:
We reviewed medical records of 456 patients who had undergone pancreatoduodenectomy at Seoul National University Hospital between January 1991 and December 2000.RESULTS:
Postoperative bleeding occurred in 21 patients. Early hemorrhage within the postoperative 5th day amounted 5 cases, which were caused by improper intra-operative hemostasis. Three of these patients were saved by prompt surgery and, in one patient, conservative management. Late hemorrhage after the postoperative 5th day included 16 cases, of which 12 patients (75%) were associated with pancreas anastomotic leaks and 8 patients displayed pseudoaneurysm. "Sentinel bleeding" was evident in 8 cases. Angiographic embolization was performed in 8 cases, achieving hemostasis in 7 cases. Reoperations were attempted in 7 cases with complete hemostasis in 2 cases. As a result, 15 of 21 patients obtained complete hemostasis and mortality rate from postoperative hemorrhage was 28.6% (6/21).CONCLUSION:
Successful hemostasis was achieved by surgery in case of early hemorrhage and by angiographic embolization in late hemorrhage. In order to prevent hemorrhage following pancreatoduodenectomy, meticulous hemostasis and considerate operative techniques for avoiding pancreatic anastomotic leaks or vascular injury are essential.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pâncreas
/
Prontuários Médicos
/
Mortalidade
/
Pancreaticoduodenectomia
/
Falso Aneurisma
/
Hemorragia Pós-Operatória
/
Fístula Anastomótica
/
Lesões do Sistema Vascular
/
Seul
/
Hemorragia
Tipo de estudo:
Estudo prognóstico
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Coreano
Revista:
Journal of the Korean Surgical Society
Ano de publicação:
2002
Tipo de documento:
Artigo
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