Iswanto Sucandy, Nussbaum Michael L
Department of Surgery, Abington Memorial Hospital, Abington, Pennsylvania, USA.
N Am J Med Sci. 2014 Jun;6(6):287-90. doi: 10.4103/1947-2714.134377.
Delayed intra-abdominal bleeding related to hepatic artery pseudoaneurysm is a potentially lethal complication after pancreaticoduodenectomy for pancreatic cancer. Locally advanced tumors, which result in vessel erosion or extensive operative skeletonization, may contribute to weakness of the arterial wall. Reoperation is often technically difficult with high rate of mortality; therefore, alternative less invasive options are ideal.
The study was to present an alternative endovascular treatment of a large hepatic artery pseudoaneurysm after pancreatic resection for locally advanced multicystic adenocarcinoma.
Transcatheteric mesenteric angiography with deployment of detachable coils in the pseudoaneurysm sac was utilized to manage the hepatic artery pseudoaneurysm.
Completion angiography confirmed cessation of contrast enhancement in the pseudoaneurysm sac with preservation of normal antegrade hepatic artery flow.
Minimally invasive angiographic technique is the preferred treatment for hepatic artery pseudoaneurysm after pancreatic resections.
与肝动脉假性动脉瘤相关的延迟性腹腔内出血是胰腺癌胰十二指肠切除术后一种潜在的致命并发症。局部进展期肿瘤可导致血管侵蚀或广泛的手术骨骼化，这可能会导致动脉壁薄弱。再次手术在技术上通常很困难，死亡率很高；因此，替代的侵入性较小的选择是理想的。
本研究旨在介绍一种针对局部进展期多囊性腺癌胰腺切除术后大型肝动脉假性动脉瘤的替代性血管内治疗方法。
采用经导管肠系膜血管造影并在假性动脉瘤腔内放置可脱卸弹簧圈来处理肝动脉假性动脉瘤。
造影剂注入完成后血管造影证实假性动脉瘤腔内造影剂增强停止，肝动脉正常顺行血流得以保留。
微创血管造影技术是胰腺切除术后肝动脉假性动脉瘤的首选治疗方法。
