The diagnosis and management strategies for gastrointestinal hemorrhage following pancreaticoduodenectomy / 中华外科杂志
Chinese Journal of Surgery
; (12): 685-687, 2013.
Article
in Zh
| WPRIM
| ID: wpr-301244
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the causes and clinical features of gastrointestinal hemorrhage following pancreaticoduodenectomy (PD), and to provide the management strategies for this complication.</p><p><b>METHODS</b>The clinic data of 412 patients who underwent PD from January 2000 to April 2010 was retrospectively reviewed. There were 232 male and 180 female patients, average age was (60 ± 12) years. The mode of procedure was standard PD and the Child's reconstruction of digestive tract, whose anastomosic steps encluded gastroenterostomy following chlangioenterostomy and pancreaticoenterostomy, was employed. Etiology of gastrointestinal haemorrhage, diagnostic methods and treatment strategy was recorded and analyzed.</p><p><b>RESULTS</b>The postoperative mobidity was 37.1% (153/412), the rate of haemorrhagic complications was 6.6% (27/412), and gastrointestinal hemorrhage was recorded in 11 patients (2.7%). The bleeding rate of pancreaticointestinal anastomosis and gastricointestinal anastomosis were 5/11 and 4/11, respectively. Among these 11 patients, early hemorrhage occurred in 6 patients, 7 patients were due to technical failure. In order to control this kind of complication, open abdominal operation alone was performed on 4 patients, endoscopic management was performed on 3 patients and succeeded in 2 patients, vascular interventional therapy was performed on 5 patients and succeeded in 2 patients, and Re-laparotomy following vascular interventional therapy was performed on 2 patients successfully.</p><p><b>CONCLUSIONS</b>Gastrointestinal hemorrhage following PD always occurred in early stage and reliable hemostasis during operation is the key points for prevention. Angiography is minimally invasive and holds the diagnostic value. Timely and decisive reoperation is an important method to management of postoperative gastrointestinal hemorrhage.</p>
Full text:
1
Index:
WPRIM
Main subject:
Therapeutics
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Retrospective Studies
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Treatment Outcome
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Pancreaticoduodenectomy
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Postoperative Hemorrhage
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Gastrointestinal Hemorrhage
Type of study:
Observational_studies
Limits:
Aged
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Female
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Humans
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Male
Language:
Zh
Journal:
Chinese Journal of Surgery
Year:
2013
Type:
Article