Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy  

作　　者：Xiaoye Li Shibo Xia Liangxi Yuan Lei Zhang Chao Song Xiaolong Wei Qingsheng Lu 

机构地区：[1]Department of General Surgery,No.929 Hospital,Naval Medical University,Shanghai,200433,China [2]Vascular Surgery,Department of General Surgery,Changhai Hospital,Naval Medical University,Shanghai,200433,China

出　　处：《Chinese Journal of Traumatology》2025年第1期7-12,共6页中华创伤杂志(英文版)

基　　金：supported by the 234 Discipline Climbing Program,A multicenter study of robotic treatment of dilated aortic disease by endovascular repair,2019YXK048.

摘　　要：Purpose:Postpancreatectomy hemorrhage(PPH)is a life-threatening complication after pancreatoduodenectomy.Stent-graft implantation is an emerging treatment option for PPH.This study reports the outcome of PPH treated with stent-graft implantation.Methods:This was a single-center,retrospective study.Between April 2020 and December 2023,1723 pancreatectomy cases were collected while we screened 12 cases of PPH after pancreatoduodenectomy treated with stent-graft implantation.Patients'medical and radiologic images were retrospectively reviewed.Technical and clinical success,complications,and stent-graft patency were evaluated.Continuous data are reported as means±standard deviation when normally distributed or as median(Q1,Q3)when the data is non-normal distributed.Categorical data are reported as n(%).A p<0.05 was considered statistically significant.Kaplan-Meier estimates were used for stent patency and patients'survival.Results:Pancreatic fistula was identified in 6 cases(50.0%),and pseudoaneurysm was identified in 3 cases(25.0%),including pancreatic fistula together with pseudoaneurysm in 1 case(8.3%).All pseudoaneurysm or contrast extravasation sites were successfully excluded with patent distal perfusion,thus technical success was achieved in all cases.The overall survival rate at 6 months and 1 year was 91.7%and 78.6%,respectively.One patient had herniation of the small intestine into the thoracic cavity,which caused a broad thoracic and abdominal infection and died during hospitalization.Rebleeding occurred at the gastroduodenal artery stump in 1 case after stent-graft implantation for the splenic artery and was successfully treated with another stent-graft implantation.Two cases of asymptomatic stent-graft occlusion were observed at 24.6 and 26.3 after the operation,respectively.Conclusions:With suitable anatomy,covered stent-graft implantation is an effective and safe treatment option for PPH with various bleeding sites and causes.

关 键 词：PANCREATODUODENECTOMY Postpancreatectomy hemorrhage Endovascular intervention Stent-graft implantation 

分 类 号：R657.5[医药卫生—外科学]