Risk factors and prevention strategies for intraperitoneal hemorrhage after pancreaticoduodenectomy
10.16139/j.1007-9610.2024.03.10
- VernacularTitle:胰十二指肠切除术后腹腔内出血的相关因素分析及预防策略
- Author:
Wei LI
1
;
Sheng WU
;
Yujian TIAN
;
Xiaoming TANG
;
Chuang CAI
;
Zhiwei XU
Author Information
1. 无锡市中医医院 南京中医药大学无锡附属医院普外科,江苏 无锡 214071
- Keywords:
Pancreaticoduodenectomy;
Postoperative bleeding;
Related factors;
Prevention
- From:
Journal of Surgery Concepts & Practice
2024;29(3):243-248
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors and preventive strategies of pancreaticoduodenectomy postoperative hemorrhage.Methods A total of 208 patients who underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of the 904th Hospital of Joint Logistics Support Force,PLA from January 2017 to December 2021 were enrolled.Twenty-one patients with postoperative hemorrhage were retrospectively analyzed.Results Univariate analysis indicated that postoperative hemorrhage was mainly associated with pancreatic leakage,biliary leakage,abdominal infection,hypoproteinemia,diabetes,improper use of ultrasound knife,skeletonization,intraoperative blood loss,preoperative jaundice,etc.(P<0.05),but not gender and age(P>0.05).Among the 21 patients with postoperative hemorrhage,4 cases recovered after conservative treatment such as hemostasis and blood transfusion,6 cases underwent interventional treatment,11 cases underwent abdominal exploration,and 2 cases died of postoperative multiple organ failure.Pancreatic leakage(OR=3.963,95%CI:1.120-14.025),biliary leakage(OR=4.013,95%CI:1.173-13.734)and abdominal infection(OR=7.545,95%CI:1.833-31.051)were independent risk factors for postoperative hemorrhage.Conclusions The improvement of anastomotic manipulation,reduction of anastomotic leakage,and control and prevention of abdominal infection are important to prevent postoperative hemorrhage of pancreaticoduodenectomy.Surgical treatment should be performed as soon as possible for the patients with poor conservative treatment effect.
