ENDOVASCULAR METHODS OF TREATMENT POSTPANCREATECTOMY HEMORRHAGE AFTER PANCREATIC RESECTIONS

Abstract

Summary. Aim. To evaluate of the endovascular treatment of patients with postpancreatectomy hemorrhage after pancreatic resections.
 Matherials and Methods. In the period 2009-2018 we performed 728 radical pancreatic resections in patients with pancreatic cancer.
 Postpancreatectomy hemorrhage was occurred in 38 (5,2 %) patients. Mortality was 6 (15,8 %). Postpancreatectomy hemorrhage gr. A st. А was occurred in 3 patients and was treatment concervatively. Hemorrhage gr. B or C were occurred in 35 patients.
 Results. Angiography was performed in 17 (48,6 %) patients among 35. In 14 patients postpancreatectomy hemorrhage was diagnosed. In 3 (17,6 %) patients the source of the bleeding wasn’t identified, this patients underwent a laparotomy with a subsequent treatment. Interventional angiography and treatment of hemorrhage were performed in 14 (82,4 %) patients: embolization was performed in 9, stenting in 5. Mortality was occurred in 1 (7 %) patient. There were no complications after stent grafting. Open surgery was performed in 18 (51.4 %) patients. Of the 18 patients, 6 (33.3 %) died of further septic complications.
 Conclusions. Endovascular techniques to treatment of postpancreatectomy haemorrhage have proven to be highly effective and safe with good technical and clinical results. Endovascular treatment of bleeding should be the first step in the treatment of postpancreatectomy haemorrhage with stent graft placement in haemorrhage of the main vessels.