胰十二指肠切除术后迟发性出血的介入栓塞治疗

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Abstract Objective: To discuss the safety and efficacy of interventional therapy for delayed post-pancreaticoduodenectomy hemorrhage． Methods: Twenty-four patients undergoing interventional radiology treatments for delayed post-pancreaticoduodenecomy hemorrhage from July 2010 to June 2015 were included in the study. Clinical and imaging data were studied. Angiography findings, efficacy of embolization, and related complications were analyzed. The patients consisted of 16 males and 8 females with an age range of 37~74 years old. There were 14 patients of abdominal hemorrhage, 7 patients of gastrointestinal hemorrhage, 2 patients of abdominal and gastrointestinal hemorrhage, and 1 patient of hemorrhagic shock. Results: In the 24 patients, 22 patients(91.67%) had positive results of angiography. In the 22 patients, 12 patients showed pseudo-aneurysm, 7 patients showed pseudo-aneurysm and contrast media extravasation, 3 patients showed unsmooth arterial intima. Hemorrhage ceased in 19 patients(79.2%, 19/24) after interventional therapy. Two patients died of hemorrhagic shock. Four patients died of complications such as pancreatic fistula, infection shock and multi-organ failure within 1 month after the interventional therapy. Six patients died of tumor deterioration within 3~16 months. The rest 12 patients did not develop massive hemorrhage within 3~24 months. Four patients showed transient liver damage. Three patients with spleen arterial embolism and 2 patients with hepatic artery embolism showed limited extent of infarction. None of the patients showed severe complications such as intestinal necrosis or pancreatic necrosis. Conclusion: The interventional therapy is a safe and effective technique, and should be the first-line diagnosis and treatment choice for patients with post-pancreaticoduodenectomy hemorrhage．

Key words： Pancreaticoduodenectomy Hemorrhage Embolization, theraprutic

Received: 13 April 2016

PACS:	Ｒ657.5
	Ｒ656.64
	Ｒ815

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	WANG Chuan-zhuo
	LIU Zhao-yu

Cite this article:

WANG Chuan-zhuo,LIU Zhao-yu. Interventional therapy for delayed post-pancreaticoduodenectomy hemorrhage[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(12): 899-903.

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http://www.jccmi.com.cn/EN/ OR http://www.jccmi.com.cn/EN/Y2016/V27/I12/899

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