Xiaohe Yu1,2, Xue Liu1, Jian Huang1, Shuqun Shen1, Naijian Ge1, Yefa Yang1, Hua Wang1,3. 1. Department of Radioactive Intervention, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China. 2. Department of Critical Care Medicine, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai, China. 3. Intervention and Vascular Surgery, Jiading Branch of Shanghai First People's Hospital, Shanghai, China.
Abstract
BACKGROUND: Angiography and subsequent endovascular therapy is an effective technique for delayed postoperative arterial hemorrhage (PAH) after hepatobiliary pancreatic surgery. In this research, we aimed to evaluate endovascular therapy choices for different sites of delayed PAH after hepatobiliary pancreatic surgery. METHODS: A total of 85 patients with delayed PAH who underwent endovascular therapy at the Department of Radioactive Intervention of Eastern Hepatobiliary Surgery Hospital were retrospectively enrolled. According to the hemorrhage site, participants were divided into 3 groups, all of whom then received embolization, covered stent placement, or a combination of both. Ongoing or recurrent hemorrhages, intervention times, complications associated with intervention, and mortality rate were documented. The chi-squared (χ2) test was used for statistical analysis. RESULTS: A total of 22 participants with arterial branch hemorrhage underwent superselective embolization. Overall, 81.8% (18/22) of patients underwent embolization once. The successful hemostasis rate was 77.3% (17/22), and the mortality rate was 13.6% (3/22). A total of 53 participants with arterial trunk hemorrhage underwent embolization or covered stent placement. The rate of multi-time intervention, failure to achieve hemostasis, complications associated with intervention, and mortality was lower in the stent group than in the embolization group, and there was a significant difference in complications between the 2 groups (χ2=4.93, P=0.026). Among a total of 10 patients with multisite hemorrhage who underwent embolization, covered stent placement, or a combination, the successful hemostasis rate was 20%; and the mortality rate was 70%. CONCLUSIONS: Superselective embolization is a safe treatment method for arterial branch hemorrhage, and covered stent placement may be a better choice for arterial trunk hemorrhage. Verification of these findings is required via additional large population studies. 2021 Gland Surgery. All rights reserved.
BACKGROUND: Angiography and subsequent endovascular therapy is an effective technique for delayed postoperative arterial hemorrhage (PAH) after hepatobiliary pancreatic surgery. In this research, we aimed to evaluate endovascular therapy choices for different sites of delayed PAH after hepatobiliary pancreatic surgery. METHODS: A total of 85 patients with delayed PAH who underwent endovascular therapy at the Department of Radioactive Intervention of Eastern Hepatobiliary Surgery Hospital were retrospectively enrolled. According to the hemorrhage site, participants were divided into 3 groups, all of whom then received embolization, covered stent placement, or a combination of both. Ongoing or recurrent hemorrhages, intervention times, complications associated with intervention, and mortality rate were documented. The chi-squared (χ2) test was used for statistical analysis. RESULTS: A total of 22 participants with arterial branch hemorrhage underwent superselective embolization. Overall, 81.8% (18/22) of patients underwent embolization once. The successful hemostasis rate was 77.3% (17/22), and the mortality rate was 13.6% (3/22). A total of 53 participants with arterial trunk hemorrhage underwent embolization or covered stent placement. The rate of multi-time intervention, failure to achieve hemostasis, complications associated with intervention, and mortality was lower in the stent group than in the embolization group, and there was a significant difference in complications between the 2 groups (χ2=4.93, P=0.026). Among a total of 10 patients with multisite hemorrhage who underwent embolization, covered stent placement, or a combination, the successful hemostasis rate was 20%; and the mortality rate was 70%. CONCLUSIONS: Superselective embolization is a safe treatment method for arterial branch hemorrhage, and covered stent placement may be a better choice for arterial trunk hemorrhage. Verification of these findings is required via additional large population studies. 2021 Gland Surgery. All rights reserved.
Authors: Song-I Bae; Jong Eun Yeon; Jong Mee Lee; Ji Hoon Kim; Hyun Jung Lee; Sun Jae Lee; Sang Jun Suh; Eileen L Yoon; Hae Rim Kim; Kwan Soo Byun; Tae-Seok Seo Journal: Clin Mol Hepatol Date: 2012-09-25
Authors: Kevin C Ching; Ernesto Santos; Kevin M McCluskey; Phillip D Orons; Rupal Bandi; Christopher J Friend; Minzhi Xing; Amer H Zureikat; Herbert J Zeh Journal: J Vasc Interv Radiol Date: 2015-11-21 Impact factor: 3.464
Authors: Radu Dumitru; Ana Carbunaru; Mugur Grasu; Mihai Toma; Mihnea Ionescu; Traian Dumitrascu Journal: Ann Hepatobiliary Pancreat Surg Date: 2016-11-30