Diagnosis and management of postoperative gastrointestinal bleeding after pancreaticoduodenectomy
10.3760/cma.j.issn.1007-8118.2012.10.011
- VernacularTitle:胰十二指肠切除术相关消化道出血的诊治
- Author:
Yan ZHUANG
;
Xiaodong TIAN
;
Guangdong WU
;
Weimin WANG
;
Yinmo YANG
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Hemorrhage;
Gastrointestinal tract
- From:
Chinese Journal of Hepatobiliary Surgery
2012;18(10):765-768
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo analyze the underlying causes of postoperative gastrointestinal (CI)bleeding after pancreaticoduodenectomy and to discuss the strategies in diagnosis,prevention and management.MethodsThe clinical data of 331 patients who were admitted to the Surgical Department of the First Hospital,Peking University from Jan. 1998 to Jan. 2010 was retrospectively analyzed.ResultsThe overall postoperative morbidity was 37.2 %,with a bleeding complication rate of 6.7 %,and a GI bleeding rate of 1.5%.For postoperative GI bleeding,the main bleeding sites were from the pancreaticointestinal anastomosis (40.0%) and the gastrointestinal anastomosis (20.0%). Embolotherapy using vascular intervention alone (20.0%),open abdominal operation following vascular interventional therapy (40.0 % ) and open abdominal operation alone (40.0 % ) were used to control GIbleeding.ConclusionsThe common bleeding sites in the GI tract were at the pancreaticointestinal anastomosis and the gastrointestinal anastomosis. The main procedures used to control bleeding were embolization using vascular interventional therapy,endoscopic therapy and open abdominal therapy.