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Solodkiy V.A.

Russian Research Center of Radiology

Kriger A.G.

Russian Research Center of Radiology;
Russian Medical Academy of Postgraduate Education

Gorin D.S.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Goev A.A.

Russian Medical Academy of Postgraduate Education;
Federal State University of Education

Varava A.B.

Vishnevsky Center of Surgery

Panteleev V.I.

National Radiology Research Center;
Plekhanov Russian University of Economics

Hemorrhage after pancreaticoduodenectomy

Authors:

Solodkiy V.A., Kriger A.G., Gorin D.S., Goev A.A., Varava A.B., Panteleev V.I.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2025;(1): 14‑21

DOI: 10.17116/hirurgia202501114

Views: 561

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Table of contents

HEMORRHAGE AFTER PANCREATICODUODENECTOMY
HEMORRHAGE AFTER PANCREATICODUODENECTOMY

To cite this article:

Solodkiy VA, Kriger AG, Gorin DS, Goev AA, Varava AB, Panteleev VI. Hemorrhage after pancreaticoduodenectomy. Pirogov Russian Journal of Surgery. 2025;(1):14‑21. (In Russ.)
https://doi.org/10.17116/hirurgia202501114

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
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OBJECTIVE

To analyze the incidence, clinical manifestations and treatment of post-pancreaticoduodenectomy hemorrhage in patients with pancreaticoduodenal tumors.

MATERIAL AND METHODS

There were 362 pancreaticoduodeneectomies for ductal adenocarcinoma of the pancreatic head and pancreatoduodenal tumors in 2016—2023. Post-pancreatectomy hemorrhage (PPH) occurred in 52 (14.4%) patients. Delayed post-pancreatectomy hemorrhage followed postoperative pancreatitis, pancreatic fistula or non-drained fluid collections. Bleeding was diagnosed considering clinical manifestations with verification through contrast-enhanced CT.

RESULTS

Emergency re-laparotomy was required in 15 (28.8%) patients with unstable hemodynamics; 9 (60%) people died. Thirty-seven patients with stable hemodynamics underwent emergency contrast-enhanced CT and subsequent endovascular hemostasis. Bleeding was stopped in 31 patients (89.2%). Endovascular hemostasis was ineffective in 1 patient who underwent re-laparotomy. We found no the cause of bleeding in 3 patients, and there was no hemorrhage recurrence. Six (18.7%) people died. The overall mortality among patients with PPH was 28.8% (15 out of 52 postoperative patients).

CONCLUSION

PPH follows postoperative pancreatitis, pancreatic fistula or non-drained fluid collection. In case of stable hemodynamics, endovascular hemostasis is preferable for this complication.

Keywords:

pancreaticoduodenectomy
post-pancreatectomy hemorrhage
relaparotomy
endovascular hemostasis

Authors:

Solodkiy V.A.

Russian Research Center of Radiology

Kriger A.G.

Russian Research Center of Radiology;
Russian Medical Academy of Postgraduate Education

Gorin D.S.

National Medical Research Center of Surgery named after A.V. Vishnevsky of Ministry of health of the Russian Federation

Goev A.A.

Russian Medical Academy of Postgraduate Education;
Federal State University of Education

Varava A.B.

Vishnevsky Center of Surgery

Panteleev V.I.

National Radiology Research Center;
Plekhanov Russian University of Economics

Received:

14.03.2024

Accepted:

22.04.2024

List of references:

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  3. Solodkiy VA, Kriger AG, Gorin DS, Dvukhzhilov MV, Akhaladze GG, Goncharov SV, Panteleev VI, Shuinova EA. Pancreaticoduodenectomy — results and prospects (two-center study). Pirogov Russian Journal of Surgery. 2023;(5):13-21. (In Russ.). https://doi.org/10.17116/hirurgia202305113
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