Efficacy of interventional therapy for post-pancreaticoduodenectomy hemorrhage and factors influencing rebleeding
10.3969/j.issn.1008-794X.2025.06.014
- VernacularTitle:胰十二指肠切除术后出血的介入治疗再出血的影响因素
- Author:
Zhengyu JIANG
1
;
Yu YIN
;
Jun YANG
;
Mingming LI
;
Xiaoli ZHU
;
Bangjian ZHOU
;
Caifang NI
Author Information
1. 215000 江苏苏州 苏州大学附属第一医院介入科
- Keywords:
post-pancreaticoduodenectomy hemorrhage;
interventional therapy;
rebleeding;
risk factor
- From:
Journal of Interventional Radiology
2025;34(6):639-644
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the DSA imaging characteristics and efficacy of interventional treatment for post-pancreaticoduodenectomy hemorrhage(PPH),and to analyze the factors influencing recurrent bleeding following successful interventional hemostasis.Methods Clinical data of patients who underwent interventional treatment for PPH between January 2013 and December 2022 were retrospectively analyzed.All patients underwent DSA examination,and interventional therapy was the primary treatment option for patients with positive findings.Statistical analysis was performed on DSA angiography manifestations,bleeding sites,success rate of interventional treatment and hemostasis effectiveness.Univariate and multivariate logistic regression analysis were used to analyze the independent risk factors for rebleeding after interventional treatment for PPH.Results A total of 139 patients with PPH were included in this study.All 139 patients underwent DSA examination,with a positive rate of 82.01％(114/139)in the first examination.Major angiographic manifestations included contrast agent extravasation,pseudoaneurysm,and disrupted vascular architecture;bleeding sites included gastroduodenal artery in 45 cases(39.47％),hepatic artery in 22 cases(19.30％),and superior mesenteric artery in 32 cases(28.07％).107 patients underwent interventional treatment(81 embolization and 26 stenting),with a success rate of 91.59％(98/107).The independent risk factors for recurrent bleeding after interventional treatment in patients with PPH included preoperative bleeding(P＜0.001)and pancreatic fistula(P=0.041).Conclusion Interventional procedures for PPH can be efficient in diagnosis and treatment,with a high success rate and effective hemostasis.However,it should be noted that some patients remain at risk of recurrent bleeding after successful interventional hemostasis.
