肝胰胆手术后的动脉假性动脉瘤：单中心经验
Arterial pseudoaneurysms following hepato-pancreato-biliary surgery: a single center experience.
作者信息
Ielpo Benedetto, Caruso Riccardo, Prestera Antonio, De Luca Giuseppe Massimiano, Duran Hipolito, Diaz Eduardo, Fabra Isabel, Olivares Sergio, Quijano Yolanda, Vicente Emilio
机构信息
Department of General Surgery, Madrid Norte Sanchinarro San Pablo University Hospital. Madrid, Spain.
出版信息
JOP. 2015 Jan 31;16(1):85-9. doi: 10.6092/1590-8577/2907.
CONTEXT
Arterial pseudoaneurysm is an uncommon lethal complication following hepato-pancreato-biliary surgery.
OBJECTIVE
Aim of this study is to present and discuss the experience of a high volume oncological center.
METHODS
Since 2007 all major surgeries performed at Sanchinarro Oncological Center have been included in a prospective database looking for postoperative arterial pseudonaurysm.
RESULTS
Until June 2014, among 559 hepato-pancreato-biliary procedures, a total of 14 arterial pseudoaneurysms have been identified (2.5%). Sentinel bleeding was in 57% of cases. Failed arterial embolization occurred in 2 cases. Overall mortality rate was 28.5%. We also identified 3 asymptomatic pseudoaneurysms, one of them managed without embolization, developing a sudden bleeding and died after surgery.
CONCLUSIONS
According to our experience, pseudoaneurysm incidence is higher than reported in current literature and it can be successfully managed through arterial embolization. Furthermore, we found 3 asymptomatic pseudoaneurysms, whose management is still controversial.
背景
动脉假性动脉瘤是肝胰胆手术后一种罕见的致命并发症。
目的
本研究旨在介绍并讨论一家大型肿瘤中心的经验。
方法
自2007年起，圣奇纳罗肿瘤中心进行的所有大手术均被纳入一个前瞻性数据库，以寻找术后动脉假性动脉瘤。
结果
截至2014年6月，在559例肝胰胆手术中，共发现14例动脉假性动脉瘤（2.5%）。57%的病例出现哨兵出血。2例动脉栓塞失败。总死亡率为28.5%。我们还发现3例无症状假性动脉瘤，其中1例未进行栓塞治疗，术后突然出血并死亡。
结论
根据我们的经验，假性动脉瘤的发生率高于当前文献报道，可通过动脉栓塞成功治疗。此外，我们发现3例无症状假性动脉瘤，其治疗仍存在争议。
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