介入放射学在胰十二指肠切除术后迟发性出血管理中的作用。
The Role of Interventional Radiology in the Management of Late Postpancreaticoduodenectomy Hemorrhage.
机构信息
Department of Interventional Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, No. 160 Pujian Road, Pudong, Shanghai 200127, China.
出版信息
Biomed Res Int. 2020 Dec 13;2020:8851950. doi: 10.1155/2020/8851950. eCollection 2020.
OBJECTIVE
To explore the role of interventional radiology (IR) in the management of late postpancreaticoduodenectomy hemorrhage (PPH).
MATERIALS AND METHODS
Patients who had late PPH (occurring >24 h after index operation) managed by the IR procedure in our institution between 2013 and 2018 were retrospectively analyzed.
RESULT
Hired patients who were diagnosed with grade B ( = 10) and C ( = 22) late PPH underwent 40 transcatheter arterial angiographies (TAA). The overall positive rate of angiography was 45.0% (18/40). Eighteen transcatheter arterial embolizations (TAEs) were performed, and the technical success rate was 88.89% (16/18). The rebleeding rate after embolization was 18.8% (3/16), and no severe procedure-related complications were recorded. The overall mortality of late PPH was 25.0% (8/32).
CONCLUSION
Nearly half of hemorrhagic sites in late PPH could be identified by TAA. TAE is an effective and safe method for the hemostasia of late PPH in patients with positive angiography results.
目的
探讨介入放射学（IR）在处理胰十二指肠切除术后迟发性出血（PPH）中的作用。
材料与方法
回顾性分析 2013 年至 2018 年期间我院因迟发性 PPH（发生于指数手术后 >24 小时）而行 IR 治疗的患者。
结果
诊断为迟发性 PPH 分级 B（=10 例）和 C（=22 例）的患者行 40 次经导管动脉血管造影术（TAA）。血管造影的总体阳性率为 45.0%（18/40）。行 18 次经导管动脉栓塞术（TAE），技术成功率为 88.89%（16/18）。栓塞后再出血率为 18.8%（3/16），无严重与操作相关的并发症。迟发性 PPH 的总死亡率为 25.0%（8/32）。
结论
TAA 可识别近半数迟发性 PPH 的出血部位。TAE 是对有阳性血管造影结果的患者进行迟发性 PPH 止血的有效且安全的方法。
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