ArticleQuantitative imaging in medicine and surgery2025
Endovascular intervention and risk factor assessment for postoperative pseudoaneurysms after pancreatic surgery: a 9-year retrospective study.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Segmental hepatic necrosis following embolization for delayed hemorrhage after laparoscopic pancreaticoduodenectomy: a case report.Frontiers in medicine · 2026Article
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Abstract
Background: Postoperative hemorrhage is one of the most critical complications of pancreatic surgery. Pseudoaneurysm formation in postoperative hemorrhage is rare in the clinic. In this study, the safety and efficacy of intravascular intervention for pseudoaneurysm after pancreatic surgery were evaluated, and the risk factors associated with pseudoaneurysm formation after pancreatic surgery were analyzed. The aim of the study was to provide valuable clinical guidance for the effective prevention and treatment of such complications. Methods: A total of 153 patients with delayed pancreatic postoperative hemorrhage treated at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from April 2015 to April 2024 were retrospectively analyzed, including 76 patients with pseudoaneurysm who were treated with different intravascular interventional treatment methods (coil embolization or covered stent implantation). To evaluate the safety and efficacy of hemostasis, univariate analysis and multiple logistic regression were used to analyze the risk factors for pseudoaneurysm formation. Results: Among the 76 patients with pseudoaneurysm, the majority underwent pancreaticoduodenectomy (n=39; 51.3%), and the most common initial clinical presentation was bleeding through the surgical drainage tube (n=36, 47.4%). The main vessels invaded were the common hepatic artery and branches (n=25, 32.9%), the superior mesenteric artery and branches (n=22, 28.9%), the gastroduodenal artery and branches (n=12, 15.8%), and the splenic artery (n=11, 14.5%). The technical success rate of both coil embolization and covered stent implantation was 100%. The survival rate during hospitalization was 90.8%. None of the survivors experienced rebleeding at the treatment site during follow-up. The univariate analysis identified preoperative total bilirubin >17.1 µmol/L, preoperative and postoperative albumin <30 g/L, postoperative hemoglobin <90 g/L, operative time >6 hours, pancreatic fistula, and abdominal infection as risk factors of postoperative pseudoaneurysm formation (P<0.05). Multivariate logistic regression analysis confirmed that postoperative albumin <30 g/L, pancreatic fistula, and abdominal infection were independent risk factors for postoperative pseudoaneurysm formation (P<0.05). Conclusions: Endovascular intervention is a safe and effective method for the treatment of pseudoaneurysm caused by delayed hemorrhage after pancreatic surgery. In this study, postoperative albumin <30 g/L, pancreatic fistula, and intraperitoneal infection were identified as independent risk factors for pseudoaneurysm formation after pancreatic surgery. Monitoring the levels of serum albumin and hemoglobin after surgery, early detection of pancreatic fistula, and early use of sensitive antibiotics to control abdominal infection may reduce the occurrence of postoperative pancreatic pseudoaneurysm, decrease the risk of hemorrhage, and improve prognosis.
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