ArticleWorld journal of hepatology2021
Fatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic arterial flow?
Article in World journal of hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 11 citations in OpenAlex.
- Parenchymal Injury Caused by Complete Migration of a Bone of Japanese Horse Mackerel Within the Pancreatic Uncinate Process Through a Duodenal Diverticulum, Resulting in Sepsis and Multiple Pyogenic Liver Abscesses.The American journal of case reports · 2026Article
- Stent-graft implantation for hepatic arterial bleeding: a systematic review and meta-analysis.CVIR endovascular · 2025Review
- Hepatic artery stenting with Viabahn.CVIR endovascular · 2024Article
- Life-threatening event in laparoscopic hepatic surgery: Training curriculum on sudden hepatic artery haemorrhage.World journal of emergency surgery : WJES · 2024Article
- Usefulness of the hybrid technique of interventional radiology and endoscopic treatment for intestinal bleeding after pancreaticoduodenectomy: a case report.Annals of medicine and surgery (2012) · 2024Article
- Endovascular treatment for delayed post-pancreaticoduodenectomy hemorrhage of unusual origin (splenic artery branch).Journal of vascular surgery cases and innovative techniques · 2022Article
- Covered stent placement for gastroduodenal artery stump hemorrhage after pancreaticoduodenectomy: long-term patency and risk factor of stent failure.The British journal of radiology · 2022Article
- Hepatoprotective role of peroxisome proliferator-activated receptor-α in non-cancerous hepatic tissues following transcatheter arterial embolization.Open life sciences · 2022Article
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Authors and funding
16 authors at 1 institution in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough arterial hemorrhage after pancreaticoduodenectomy (PD) is not frequent, it is fatal. Arterial hemorrhage is caused by pseudoaneurysm rupture, and the gastroduodenal artery stump and hepatic artery (HA) are frequent culprit vessels. Diagnostic procedures and imaging modalities are associated with certain difficulties. Simultaneous accomplishment of complete hemostasis and HA flow preservation is difficult after PD. Although complete hemostasis may be obtained by endovascular treatment (EVT) or surgery, liver infarction caused by hepatic ischemia and/or liver abscesses caused by biliary ischemia may occur. We herein discuss therapeutic options for fatal arterial hemorrhage after PD.
aimTo present our data here along with a discussion of therapeutic strategies for fatal arterial hemorrhage after PD.
methodsWe retrospectively investigated 16 patients who developed arterial hemorrhage after PD. The patients' clinical characteristics, diagnostic procedures, actual treatments [transcatheter arterial embolization (TAE), stent-graft placement, or surgery], clinical courses, and outcomes were evaluated.
resultsThe frequency of arterial hemorrhage after PD was 5.5%. Pancreatic leakage was observed in 12 patients. The onset of hemorrhage occurred at a median of 18 d after PD. Sentinel bleeding was observed in five patients. The initial EVT procedures were stent-graft placement in seven patients, TAE in six patients, and combined therapy in two patients. The rate of technical success of the initial EVT was 75.0%, and additional EVTs were performed in four patients. Surgical approaches including arterioportal shunting were performed in eight patients. Liver infarction was observed in two patients after TAE. Two patients showed a poor outcome even after successful EVT. These four patients with poor clinical courses and outcomes had a poor clinical condition before EVT. Fourteen patients were successfully treated.
conclusionTranscatheter placement of a covered stent may be useful for simultaneous accomplishment of complete hemostasis and HA flow preservation.
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