Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy
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...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127524001512 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832586263398449152 |
|---|---|
| author | Xiaoye Li Shibo Xia Liangxi Yuan Lei Zhang Chao Song Xiaolong Wei Qingsheng Lu |
| author_facet | Xiaoye Li Shibo Xia Liangxi Yuan Lei Zhang Chao Song Xiaolong Wei Qingsheng Lu |
| author_sort | Xiaoye Li |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-613f419b2674474db3996b1d333f0c4a |
| institution | Kabale University |
| issn | 1008-1275 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj-art-613f419b2674474db3996b1d333f0c4a2025-01-26T05:03:29ZengElsevierChinese Journal of Traumatology1008-12752025-01-01281712Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomyXiaoye Li0Shibo Xia1Liangxi Yuan2Lei Zhang3Chao Song4Xiaolong Wei5Qingsheng Lu6Department of General Surgery, No. 929 Hospital, Naval Medical University, Shanghai, 200433, ChinaVascular Surgery, Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, ChinaVascular Surgery, Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, ChinaVascular Surgery, Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, ChinaVascular Surgery, Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, ChinaVascular Surgery, Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, ChinaVascular Surgery, Department of General Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, China; Corresponding author.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.http://www.sciencedirect.com/science/article/pii/S1008127524001512PancreatoduodenectomyPostpancreatectomy hemorrhageEndovascular interventionStent-graft implantation |
| spellingShingle | Xiaoye Li Shibo Xia Liangxi Yuan Lei Zhang Chao Song Xiaolong Wei Qingsheng Lu Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy Chinese Journal of Traumatology Pancreatoduodenectomy Postpancreatectomy hemorrhage Endovascular intervention Stent-graft implantation |
| title | Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy |
| title_full | Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy |
| title_fullStr | Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy |
| title_full_unstemmed | Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy |
| title_short | Stent-graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy |
| title_sort | stent graft implantation for late postpancreatectomy hemorrhage after pancreatoduodenectomy |
| topic | Pancreatoduodenectomy Postpancreatectomy hemorrhage Endovascular intervention Stent-graft implantation |
| url | http://www.sciencedirect.com/science/article/pii/S1008127524001512 |
| work_keys_str_mv | AT xiaoyeli stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy AT shiboxia stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy AT liangxiyuan stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy AT leizhang stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy AT chaosong stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy AT xiaolongwei stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy AT qingshenglu stentgraftimplantationforlatepostpancreatectomyhemorrhageafterpancreatoduodenectomy |