Diagnosis and treatment efficacy of digital subtraction angiography and transcatheter arterial embolization in post-pancreatectomy hemorrhage: A single center retrospective cohort study.

BACKGROUND

To evaluate the diagnostic and treatment efficacy of digital subtraction angiography (DSA), transcatheter arterial embolization (TAE) in post-pancreatectomy hemorrhage (PPH).

MATERIALS AND METHODS

This is a single-center retrospective cohort study. Clinicopathological data of 23 patients with PPH from August 2009 to November 2016 were collected. We observed (1) DSA procedures and hemorrhagic sites (2) TAE: successful rate and complications (3) Follow-up.

RESULTS

(1) 30 procedures of DSA were conducted in 23 patients, 20 (66.7%) procedures of contrast medium extravasation were observed. Among 20 procedures of positive DSA, hemorrhagic site located 5 times in gastroduodenal artery,4 times in common hepatic artery, 3 times in superior mesenteric artery, 3 times in splenic artery, 1 time in left gastric artery, right gastric artery, left hepatic artery, right hepatic artery and inferior mesenteric artery respectively. (2) Besides 4 failure procedures of TAE managed by surgery, 16 procedures of TAE were conducted, with 14 successful hemostasis. 2 procedures of post-TAE re-hemorrhage were managed by surgery. In 9 patients with 10 procedures of negative DSA, 9 had conservative treatment and 1 was managed by surgery. (3) 6 patients died because of the metastasis, median survival time was 7.5 months.

CONCLUSIONS

DSA is minimal invasive in the diagnosis of PPH, and TAE is safe and effective for patients with positive DSA.