Stent-grafts placement for treatment of massive hemorrhage from ruptured hepatic artery after pancreaticoduodenectomy
Open Access
- 1 January 2010
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 16 (29), 3716-3722
- https://doi.org/10.3748/wjg.v16.i29.3716
Abstract
AIM: To present a series of cases with life-threatening hemorrhage from ruptured hepatic artery pseudoaneurysm after pancreaticoduodenectomy (PD) treated with placement of stent-grafts. METHODS: Massive hemorrhage from ruptured hepatic artery pseudoaneurysm after PD in 9 patients (6 men, 3 women) at the age of 23-75 years (mean 48 years), were treated with placement of percutaneous endovascular balloon-expandable coronary stent-grafts. All patients were not suitable for embolization because of a non-patent portal vein. One or more stent-grafts, ranging 3-6 mm in diameter and 16-55 mm in length, were placed to exclude ruptured pseudoaneurysm. Follow-up data, including clinical condition, liver function tests, and Doppler ultrasound examination, were recorded at the outpatient clinic. RESULTS: Immediate technical success was achieved in all the 9 patients. All stent-grafts were deployed in the intended position for immediate cessation of bleeding and preservation of satisfactory hepatic arterial blood flow. No significant procedure-related complications occurred. Recurrent bleeding occurred in 2 patients at 16 and 24 h, respectively, after placement of stent-grafts and treated with surgical revision. One patient died of sepsis 12 d after the interventional procedure. The remaining 6 patients were survived when they were discharged. The mean follow-up time was 10.5 mo (range 4-16 mo). No patient had recurrent bleeding after discharge. Doppler ultrasound examination verified the patency of hepatic artery and stent-grafts during the follow-up. CONCLUSION: Placement of stent-grafts is an effective and safe procedure for acute life-threatening hemorrhage from ruptured hepatic artery pseudoaneurysm.Keywords
This publication has 28 references indexed in Scilit:
- Postpancreatectomy Hemorrhage: Diagnosis and TreatmentAnnals of Surgery, 2007
- Postpancreatectomy hemorrhage (PPH)–An International Study Group of Pancreatic Surgery (ISGPS) definitionSurgery, 2007
- Management of Massive Arterial Hemorrhage After Pancreatobiliary Surgery: Does Embolotherapy Contribute to Successful Outcome?Journal of Gastrointestinal Surgery, 2007
- Stent placement is effective on both postoperative hepatic arterial pseudoaneurysm and subsequent portal vein stricture: A case reportWorld Journal of Gastroenterology, 2007
- Stent grafting of acute hepatic artery bleeding following pancreatic head resectionEuropean Radiology, 2006
- Treatment of Coronary Artery Perforations Complicating Percutaneous Coronary Intervention With a Polytetrafluoroethylene-Covered Stent GraftThe American Journal of Cardiology, 2006
- Results of a Multicenter Trial for the Treatment of Traumatic Vascular Injury with a Covered StentThe Journal of Trauma and Acute Care Surgery, 2006
- Endovascular treatment of iliac artery aneurysms with a tubular stent-graft: Mid-term resultsJournal of Vascular Surgery, 2006
- Postoperative pancreatic fistula: An international study group (ISGPF) definitionSurgery, 2005
- Delayed Massive Hemorrhage After Pancreatic and Biliary SurgeryAnnals of Surgery, 2005