Department of Surgery, The Jikei University Daisan Hospital, Tokyo, Japan
Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Anticancer Res. 2022 Mar;42(3):1579-1588. doi: 10.21873/anticanres.15632.
BACKGROUND/AIM: Management strategies for pseudoaneurysm rupture after pancreatic resection have not yet been firmly established due to its low incidence and effects of environmental variability among centers. This study aimed to provide a basis for treatment strategy improvement.
Clinical features and outcomes of 29 patients who experienced pseudoaneurysm formation or rupture following pancreatic resection were retrospectively reviewed.
The incidence of pseudoaneurysm formation was 2.8%. In 28 of 29 patients, pseudoaneurysm was identified via emergent dynamic computed tomography (CT). The rates of complete cessation of bleeding by interventional radiology (IVR) and surgical intervention were 88% and 100%, respectively. Mortality rate was 13.8%. Four patients treated by IVR died, including three of massive bleeding and one of liver failure.
Patients with suspected pseudoaneurysm rupture after pancreatic resection should undergo immediate CT. Open surgery is preferable for patients with incomplete hemostasis by IVR or those who cannot immediately undergo IVR, however, IVR is an effective alternative.
背景/目的：由于胰腺切除术后假性动脉瘤破裂的发生率较低，且各中心之间的环境变异性较大，因此其管理策略尚未得到明确确立。本研究旨在为治疗策略的改进提供依据。
回顾性分析了 29 例胰腺切除术后发生假性动脉瘤形成或破裂的患者的临床特征和结局。
假性动脉瘤形成的发生率为 2.8%。在 29 例患者中的 28 例中，通过紧急动态计算机断层扫描（CT）发现了假性动脉瘤。介入放射学（IVR）和手术干预完全停止出血的比例分别为 88%和 100%。死亡率为 13.8%。4 例行 IVR 治疗的患者死亡，其中 3 例因大出血，1 例因肝功能衰竭。
胰腺切除术后疑似假性动脉瘤破裂的患者应立即进行 CT 检查。对于 IVR 不能完全止血或不能立即进行 IVR 的患者，开放性手术是首选，但 IVR 是一种有效的替代方法。
