Petrovic Igor, Romic Ivan, Alduk Ana M, Ticinovic Nino, Koltay Oliver M, Brekalo Klara, Bogut Ante
Department of Hepatobiliary Surgery and Transplantation, University Hospital Center Zagreb, Zagreb 10000, Croatia.
Department of Surgery, University Hospital Centre Zagreb, Zagreb 10000, Croatia.
World J Clin Cases. 2024 Nov 6;12(31):6462-6471. doi: 10.12998/wjcc.v12.i31.6462.
Pancreatic resection is still associated with high morbidity rates and delayed postpancreatectomy hemorrhage (PPH) is the most feared complication as it may lead to hemorrhagic shock or serious septic complications. Today, endovascular approach represent safe and efficient method for minimally invasive management of extraluminal PPH.
We describe four patients whose postoperative recovery after pancreatic resection was complicated by postoperative pancreatic fistula (POPF) and visceral artery hemorrhage. In all cases endovascular approach was utilized and it resulted in satisfactory outcomes. We discuss modern diagnostic and therapeutic approach in this clinical scenario.
PPH is relatively uncommon, but it is a leading cause of surgical mortality after pancreatic surgery. Careful monitoring and meticulous follow-up are required for all patients post-operatively, especially in the case of confirmed POPF, which is the most significant risk factor for the development of a PPH. Angiography as a diagnostic and therapeutic method may be an optimal first-line treatment for the management of delayed PPHs. In our experience, endovascular treatment for hemorrhagic complications of pancreatic resections has shown satisfactory results.
胰腺切除术的发病率仍然很高，胰十二指肠切除术后延迟出血（PPH）是最可怕的并发症，因为它可能导致失血性休克或严重的感染并发症。如今，血管内介入方法是微创治疗腔外PPH的安全有效方法。
我们描述了4例胰腺切除术后恢复过程中并发术后胰瘘（POPF）和内脏动脉出血的患者。所有病例均采用血管内介入方法，结果令人满意。我们讨论了这种临床情况下的现代诊断和治疗方法。
PPH相对少见，但它是胰腺手术后手术死亡的主要原因。所有患者术后都需要仔细监测和精心随访，尤其是在确诊为POPF的情况下，POPF是发生PPH的最重要危险因素。血管造影作为一种诊断和治疗方法可能是治疗延迟性PPH的最佳一线治疗方法。根据我们的经验，胰腺切除术后出血并发症的血管内治疗已显示出令人满意的结果。
