Diagnosis and management for peripancreatic pseudoaneurysms / 中华普通外科杂志

ABSTRACT

Objective To summarize the experience of diagnosis and treatment for peripancreatic pseudoanemysms.Methods The clinical data of 12 patients with peripancreatic pseudoaneurysm were analyzed retrospectively.Out of 12 patients,6 presented with abdominal or alimentary tract bleeding because of pseudoaneurysm rupture.Possible etiology included chronic pancreatitis (6 cases),severe acute pancreatitis (3 cases),postpancreatoduedenectomy (3 cases),developed after transarterial chemoembolisition for hepatic carcinoma (1 case) and 1 without any definitive cause.Results Interventional radiology as first therapeutic procedure was carried out in 10 patients including 9 endovascular coil embolizations and 1 stent graft placement for pseudoaneurysm from branch of SMA,and bleeding was controlled successfully in 5 patients with pseudoaneurysm rupture.2 patients underwent laparotomy as initial therapy.Three patients underwent surgeries after a failed embolisation,another underwent laparotomy and peritoneal lavage and drainage for pancreaticoenteric anastomotic leak complicated with abdominal infection.2 SAP patients underwent ultrasound guided drainage for peripancreatic abscess.2 after PD patients died,with mortality of 16.7％ (2/12).Conclusions Peripancreatic pseudoaneurysm carried a high and an unpredictable risk of rupture that warranted prompt interventional treatment or surgery.