Biomedical Research

All submissions of the EM system will be redirected to Online Manuscript Submission System. Authors are requested to submit articles directly to Online Manuscript Submission System of respective journal.

Research Article - Biomedical Research (2017) Volume 28, Issue 1

Sentinel bleeding after a pancreaticoduodenectomy: whether to perform a prophylactic embolization

To present a retrospective post-pancreaticoduodenectomy case series that had sentinel bleeding after pancreaticoduodenectomy and to evaluate the necessity and safety of prophylactic embolization. Fifteen post-pancreaticoduodenectomy patients with sentinel bleeding after pancreaticoduodenectomy were included in this study. Digital subtraction angiography was performed 6 hours after sentinel bleeding was detected; 8 patients received a prophylactic embolization, while 7 patients received digital subtraction angiography only. If a delayed massive hemorrhage occurred, intensive treatment such as a laparotomy or Transcatheter Angiographic Embolization (TAE) was performed. Fourteen (93.3%) patients’ angiographic findings were negative, and 1 patient had a pseudoaneurysm. All 8 prophylactic embolization patients were alive, and no delayed massive hemorrhage occurred. The delayed massive hemorrhage incidence with digital subtraction angiography was 42.8% (3 of 7), and 1 patient (14.3%) died because of a delayed massive hemorrhage. Compared with digital subtraction angiography, length of stay (p=0.048) and transfusion rates (p=0.002) decreased markedly in prophylactic embolization group. No serious complications related to prophylactic embolization were observed. Prophylactic embolization should be the treatment of choice for post-pancreaticoduodenectomy patients with sentinel bleeding, because it is safe and could reduce the postoperative length of stay and transfusion rate.

Author(s): Peng Song, Maoqiang Wang, Ning Wu, Feng Duan, Dabin Xu, Fengyong Liu

Abstract Full Text PDF