ArticleUpdates in surgery2019
Analysis of risk factors for hemorrhage and related outcome after pancreatoduodenectomy in an intermediate-volume center.
Article in Updates in surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Feasibility and clinical outcomes of omental buttress-and-wrapping to reduce postoperative complications following minimally invasive spleen-preserving distal pancreatectomy: a retrospective cohort study.Surgical endoscopy · 2026Article
- Pancreatic ductal adenocarcinoma and pancreatic surgery in the 21st century: triumphs, turning points, and unresolved challenges.Updates in surgery · 2026Review
- A predictive model for postoperative hemorrhage in patients with clinically relevant pancreatic fistula following minimally invasive pancreaticoduodenectomy.Surgical endoscopy · 2026Article
- A risk-scoring model for predicting late postoperative hemorrhage following pancreatoduodenectomy: development and external validation.Frontiers in surgery · 2026Article
- Early postpancreatectomy hemorrhage: is an update of the ISGPS definition required?Langenbeck's archives of surgery · 2025Article
- Pancreaticoduodenectomy in patients < 75 years versus ≥ 75 years old: a comparative study.Aging clinical and experimental research · 2024Article
- Machine learning approach to predict postpancreatectomy hemorrhage following pancreaticoduodenectomy: a retrospective study.Langenbeck's archives of surgery · 2024Article
- Development and Validation of a Model for Postpancreatectomy Hemorrhage Risk.JAMA network open · 2023Article
- The falciform/round ligament "flooring," an effective method to reduce life-threatening post-pancreatectomy hemorrhage occurrence.Langenbeck's archives of surgery · 2023Article
- Transcatheter arterial embolization of the common hepatic artery for pseudoaneurysm after a laparoscopic-assisted pancreaticoduodenectomy: A case report.Clinical case reports · 2023Article
- Confusing delayed hematemesis, unusual arterial hemorrhage after pancreaticoduodenectomy: a case report.The Journal of international medical research · 2022Article
- A Single-Center Retrospective Study of Selected Clinical Parameters and Intraoperative Fluid Management of Patients Undergoing Pancreatoduodenectomy.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Multiple episodes of postpancreatectomy hemorrhage resolved by endoscopy and ultrasound-guided percutaneous thrombin injection into a common hepatic artery aneurysm: a case report.The Journal of international medical research · 2021Article
- Before sentinel bleeding: early prediction of postpancreatectomy hemorrhage (PPH) with a CT-based scoring system.European radiology · 2021Article
- Delayed post-pancreatectomy hemorrhage and bleeding recurrence after percutaneous endovascular treatment: risk factors from a bi-centric study of 307 consecutive patients.Langenbeck's archives of surgery · 2021Article
- Endovascular Hepatic Artery Stents in the Modern Management of Postpancreatectomy Hemorrhage.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Prognostic factors for long-term survival after pancreaticoduodenectomy for periampullary adenocarcinoma. A retrospective cohort study.Annals of medicine and surgery (2012) · 2020Article
- Management of late hemorrhage after pancreatic surgery: treatment strategy and prognosis.The Journal of international medical research · 2020Article
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8 authors.
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Abstract
Precise risk factors for bleeding after pancreatoduodenectomy (PD) need to be further explored. We aimed to identify which variables were associated with the risk of post-pancreatectomy hemorrhage (PPH) and benchmark the PPH rate and related outcome in our intermediate-volume center with the current literature. We retrospectively analyzed 183 PD records. We investigated the association between PPH and a number of pre-surgical (age, body mass index, bilirubin plasma level, gender, American Society of Anesthesiologists classification (ASA) and smoking status, vascular hypertension), surgical (technique, additional organ resection, occlusion of the stump) and post-surgical (pancreatic fistula, bile leak and abscess development) risk factors with multivariable regression models. PPH episodes were classified and graded according to the International Study Group of Pancreatic Surgery. The overall PPH risk was 19.6%. Specific PPH mortality was 16.6%. Occurrence of PPH was increased in male patients (RR = 2.4, p = 0.001), with ASA ≥ 3 (RR = 2.1, p = 0.009) and hypertension (RR = 1.8, p = 0.04). Active smoking was protective (RR = 0.26, p = 0.001). Among postoperative factors, only pancreatic fistula increased the risk (RR = 1.6, p = 0.034). Early PPH was associated with the type of surgical reconstruction (RR 4.02, 95% CI 1.41-11.44, p = 0.009) and late PPH with pancreatic fistula (RR 2.88, 95% CI 1.06-7.83, p = 0.038). For grade C PPH, the impact of pancreatic fistula was greater (RR = 2.8, p = 0.04). Pancreatic fistula plays a crucial role in the pathogenesis of PPH. In addition, male gender, ASA ≥ 3 and hypertension increase the risk of PPH, while smoking appears protective. The PPH risk and subsequent consequences are at an acceptable rate in an intermediate-volume center.
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