Prevention and treatment of hemorrhage after pancreaticoduodenectomy
10.3760/cma.j.issn.1007-631X.2009.09.016
- VernacularTitle:胰十二指肠切除术后出血的原因及防治
- Author:
Dafang ZHANG
;
Shu LI
;
Weihua ZHU
;
Yifei FENG
;
Shengmin ZHENG
;
Jirun PENG
;
Xisheng LENG
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Postoperative hemorrhage;
Treatment
- From:
Chinese Journal of General Surgery
2009;24(9):732-735
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the prevention and treatment of postoperative hemorrhage after pancreaticoduodenectomy. Methods The clinical data of 142 patients undergoing pancreaticoduedenectomy from Jan 1995 to Dec 2008 were retrospectively analyzed. Results The incidence of postoperative hemorrhage was 14.1% (20/142), the mortality caused by this complication was 35% (7/20). Among these patients, intra-abdominal hemorrhage occurred in seven cases, and gastrointestinal hemorrhage occurred in 14 cases, with one case suffering both. There were three and four cases of early and delayed intra-abdominal hemorrhage respectively. Early and delayed gastrointestinal hemorrhage occurred in three and eleven cases respectively. Univariate analysis showed that operative blood loss, blood transfusion, infection and pancreatic fistula were significantly associated with postoperative hemorrhage. Multivariate analysis using Logistic regression identified two variables as independent factors associated with postoperative hemorrhage, namely, infection(OR=6.918) and pancreatic fistula(OR=3.948). Conclusions The incidence and mortality of hemorrhage after pancreaticoduodenectomy is still high. Skillful operation and prevention of pancreatic fistula, infection and stress ulcer are the key paints for reducing postoperative hemorrhage. Proper treatments should be used according to the site, onset and severity of hemorrhage.
