Wang Qian, Liu Geng-Geng, Pan Feng, Xu Jia-Yi, Jiao Yan, Liu Qing, Liu Ya-Hui
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.
World J Clin Oncol. 2025 Aug 24;16(8):108928. doi: 10.5306/wjco.v16.i8.108928.
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.
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。
