Suppr超能文献

胰十二指肠切除术后出血并发症预防与管理的进展:当前策略与未来方向精准。

Advances in the prevention and management of postoperative bleeding complications in pancreaticoduodenectomy: Current strategies and future directions precise.

作者信息

Wang Qian, Liu Geng-Geng, Pan Feng, Xu Jia-Yi, Jiao Yan, Liu Qing, Liu Ya-Hui

机构信息

Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China.

Science and Technology Information of Jilin Province, Changchun 130000, Jilin Province, China.

出版信息

World J Clin Oncol. 2025 Aug 24;16(8):108928. doi: 10.5306/wjco.v16.i8.108928.

Abstract

Postoperative bleeding (POB) is a major complication following pancreaticoduodenectomy (PD), leading to significant morbidity and potential mortality. This minireview focuses on the prevention and management strategies for POB, synthesizing current evidence on surgical techniques, perioperative management, and postoperative interventions. Effective prevention strategies include the use of regional vessel wrapping, optimal pancreatic anastomosis, and meticulous intraoperative hemostasis. Postoperative management strategies, such as early detection using predictive models and advanced imaging, along with endovascular interventions like angiographic embolization and stent graft placement, are essential for timely intervention. Risk factors, including pancreatic texture, anticoagulation therapy, and patient comorbidities, further influence bleeding outcomes. The minireview also identifies gaps in current research and emphasizes the need for prospective randomized controlled trials to establish standardized protocols. Overall, a multidisciplinary approach combining surgical expertise, predictive analytics, and personalized care is essential to improving patient outcomes and minimizing the risk of POB following PD.

摘要

术后出血(POB)是胰十二指肠切除术(PD)后的一种主要并发症,会导致显著的发病率和潜在的死亡率。本综述聚焦于POB的预防和管理策略,综合了有关手术技术、围手术期管理和术后干预的当前证据。有效的预防策略包括使用区域血管包裹、优化胰腺吻合以及术中细致止血。术后管理策略,如使用预测模型和先进成像进行早期检测,以及血管内介入如血管造影栓塞和支架置入术,对于及时干预至关重要。危险因素,包括胰腺质地、抗凝治疗和患者合并症,进一步影响出血结果。本综述还指出了当前研究中的差距,并强调需要进行前瞻性随机对照试验以建立标准化方案。总体而言,结合手术专业知识、预测分析和个性化护理的多学科方法对于改善患者预后和最小化PD后POB的风险至关重要。

相似文献

3
The role of sealants for achieving anastomotic hemostasis in vascular surgery.
Cochrane Database Syst Rev. 2024 May 2;5(5):CD013421. doi: 10.1002/14651858.CD013421.pub2.
4
Management of urinary stones by experts in stone disease (ESD 2025).
Arch Ital Urol Androl. 2025 Jun 30;97(2):14085. doi: 10.4081/aiua.2025.14085.
7
Prophylactic abdominal drainage for pancreatic surgery.
Cochrane Database Syst Rev. 2025 May 16;5(5):CD010583. doi: 10.1002/14651858.CD010583.pub6.
8
Postoperative nutritional support after pancreaticoduodenectomy in adults.
Cochrane Database Syst Rev. 2025 Mar 14;3(3):CD014792. doi: 10.1002/14651858.CD014792.pub2.
9
Management for intussusception in children.
Cochrane Database Syst Rev. 2017 Jun 1;6(6):CD006476. doi: 10.1002/14651858.CD006476.pub3.
10
Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews.
Cochrane Database Syst Rev. 2014 Apr 29;2014(4):CD007768. doi: 10.1002/14651858.CD007768.pub3.

本文引用的文献

1
Retrospective analysis of delta hemoglobin and bleeding-related risk factors in pancreaticoduodenectomy.
World J Gastrointest Surg. 2025 Mar 27;17(3):100999. doi: 10.4240/wjgs.v17.i3.100999.
3
Hemorrhage Sites and Mitigation Strategies After Pancreaticoduodenectomy.
JAMA Surg. 2024 Aug 1;159(8):891-899. doi: 10.1001/jamasurg.2024.1228.
7
Endovascular treatment of postoperative hemorrhage after pancreatectomy: a retrospective study.
BMC Gastroenterol. 2023 Nov 7;23(1):379. doi: 10.1186/s12876-023-03022-9.
8
Ancoaulation after pancatic urgery with venou resection (TIGRESS): What should we do? Results from an international survey.
Ann Hepatobiliary Pancreat Surg. 2023 Nov 30;27(4):423-427. doi: 10.14701/ahbps.23-065. Epub 2023 Oct 17.
9
[Pancreaticoduodenectomy - results and prospects (two-center study)].
Khirurgiia (Mosk). 2023(5):13-21. doi: 10.17116/hirurgia202305113.
10
Regional vessels wrapping following pancreaticoduodenectomy reduces the risk of post-operative extra-luminal bleeding. A systematic review.
Ann Med Surg (Lond). 2022 Sep 14;82:104618. doi: 10.1016/j.amsu.2022.104618. eCollection 2022 Oct.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验