ENDOVASCULAR INTERVENTIONS FOR PANCREATIC BLEEDINGS
I. V. Kochmashev,
M. I. Prudkov,
Yu. V. Mansurov,
V. E. Sherstobitov,
A. P. Shushanov,
S. D. Chernyshev,
F. V. Galimzyanov
https://doi.org/10.16931/1995-5464.2017230-35
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Abstract
Methods. The results of endovascular hemostasis in 42 patients with pancreatic bleeding are presented. The causes of bleeding were complications after pancreatic surgery in 8 patients, acute pancreatitis in 6 patients, chronic pancreatitis in 27 patients and pancreatic tumor in 1 case. 19 patients had gastrointestinal bleeding including hemorrhage into postnecrotic cyst in 7 patients, retroperitoneum – in 2 cases, abdominal cavity – in 6 patients, postoperative wound – in 2 cases. 6 patients had combined variants of bleeding.
Results. Bleeding source was detected by computed tomography and angiography in all patients. Technical success was achieved in 42 patients. 2 patients had recurrent bleeding in remote period due to vascular arrosion distal to covered stent with preserved collateral blood flow. Repeated embolization had stopped the bleeding in both cases.
Conclusion. Endovascular embolization is effective treatment of pancreatic bleeding. Proper organization of the treatment requires hospitalization into specialized centers.
About the Authors
I. V. Kochmashev
Sverdlovsk Regional Hospital №1
Russian Federation
Russian Federation
Kochmashev Igor Vladimirovich – Interventional Radiologist, Interventional Radiology Department
For correspondence: Kochmashev Igor Vladimirovich – Sverdlovsk Regional Hospital N1; 185, Volgogradskaya str., Ekaterinburg, 620102. Phone: +7-343-351-15-19. E-mail: kochmashev@mail.ru
M. I. Prudkov
Sverdlovsk Regional Hospital №1;
Ural State Medical University
Russian Federation
Prudkov Mikhail Iosifovich – Doct. of Med. Sci., Professor, Head of the Department of Surgical Diseases, Faculty of Advanced Education
Russian Federation
Prudkov Mikhail Iosifovich – Doct. of Med. Sci., Professor, Head of the Department of Surgical Diseases, Faculty of Advanced Education
Yu. V. Mansurov
Sverdlovsk Regional Hospital №1;
Ural State Medical University
Russian Federation
Mansurov Yury Vladimirovich – Cand. of Med. Sci., Head of Abdominal Surgery Department of Sverdlovsk Regional Hospital №1, Assistant of the Department of Surgical Diseases, Faculty of Advanced Education, Ural State Medical University
Russian Federation
Mansurov Yury Vladimirovich – Cand. of Med. Sci., Head of Abdominal Surgery Department of Sverdlovsk Regional Hospital №1, Assistant of the Department of Surgical Diseases, Faculty of Advanced Education, Ural State Medical University
V. E. Sherstobitov
Sverdlovsk Regional Hospital №1
Russian Federation
Sherstobitov Vasily Evgenyevich – Interventional Radiologist of the Interventional Radiology Department
Russian Federation
Sherstobitov Vasily Evgenyevich – Interventional Radiologist of the Interventional Radiology Department
A. P. Shushanov
Sverdlovsk Regional Hospital №1
Russian Federation
Shushanov Anton Pavlovich – Surgeon of the Abdominal Surgery Department
Russian Federation
Shushanov Anton Pavlovich – Surgeon of the Abdominal Surgery Department
S. D. Chernyshev
Sverdlovsk Regional Hospital №1
Russian Federation
Chernyshov Sergey Dmitriyevich – Head of the Interventional Radiology Department
Russian Federation
Chernyshov Sergey Dmitriyevich – Head of the Interventional Radiology Department
F. V. Galimzyanov
Sverdlovsk Regional Hospital №1;
Ural State Medical University
Russian Federation
Galimzyanov Farid Vagizovich – Doct. of Med. Sci., Head of Contaminated Surgery Department, SverdlovskRegional Hospital №1, Professor of the Department of Surgical Diseases, Faculty of Advanced Education, Ural State Medical University
Russian Federation
Galimzyanov Farid Vagizovich – Doct. of Med. Sci., Head of Contaminated Surgery Department, SverdlovskRegional Hospital №1, Professor of the Department of Surgical Diseases, Faculty of Advanced Education, Ural State Medical University
References
1. Yekebas E.F., Wolfram L., Cataldegirmen G., Habermann C.R., Bogoevski D., Koenig A.M., Kaifi J., Schurr P.G., Bubenheim M., Nolte-Ernsting C., Adam G., Izbicki J.R. Postpancreatectomy hemorrhage: diagnosis and treatment: an analysis in 1669 consecutive pancreatic resections. Ann. Surg. 2007; 246 (2): 269-280. https://doi.org/10.1097/01.sla.0000262953.77735.db.
2. Wente M.N., Veit J.A., Bassi C., Dervenis C., Fingerhut A., Gouma D.J., Izbicki J.R., Neoptolemos J.P., Padbury R.T., Sarr M.G., Yeo C.J., Büchler M.W. Postpancreatectomy hemorrhage (PPH): an international study group of pancreatic surgery (ISGPS) definition. Surgery. 2007; 142 (1): 20-25. https://doi.org/10.1016/j.surg.2007.02.001.
3. de Castro S.M., Kuhlmann K.F., Busch O.R., van Delden O.M., Lameris J.S., van Gulik T.M., Obertop H., Gouma D.J. Delayed massive hemorrhage after pancreatic and biliary surgery: embolization or surgery? Ann. Surg. 2005; 241 (1): 85-91. https://doi.org/10.1097/01.sla.0000150169.22834.13.
4. Tien Y.W., Lee P.H., Yang C.Y., Ho M.C., Chiu Y.F. Risk factors of massive bleeding related to pancreatic leak after pancreaticoduodenectomy. J. Am. Coll. Surg. 2005; 201 (4): 554-559. https://doi.org/10.1016/j.jamcollsurg.2005.05.007.
5. Ding X., Zhu J., Zhu M., Li C., Jian W., Jiang J., Wang Z., Hu S., Jiang X. Therapeutic management of hemorrhage from visceral artery pseudoaneurysms after pancreatic surgery. J. Gastrointest. Surg. 2011; 15 (8): 1417-1425. https://doi.org/10.1007/s11605-011-1561-3.
6. Gadacz T.R., Trunkey D., Kieffer R.F. Visceral vessel erosion associated with pancreatitis. Case reports and a review of the literature. Arch. Surg. 1978; 113 (12): 1438-1440.
7. Wolstenholme J.T. Major gastrointestinal haemorrhage associated with pancreatic pseudocysts. Am. J. Surg. 1974; 127 (4): 377-381.
8. Eckhauser F.E., Stanley J.C., Zelenock G.B., Borlaza G.S., Freier D.T., Lindenauer S.M. Gastroduodenal and pancreaticoduodenal artery pseudoaneurysms: a complication of pancreatitis causing spontaneous gastrointestinal haemorrhage. Surgery. 1980; 88 (3): 335-344.
9. Starling J.R., Crummy A.B. Hemosuccus pancreaticus secondary to ruptured splenic artery pseudoaneurysm. Dig. Dis. Sci. 1979; 24 (9): 726-729.
10. Lee P., Sutherland D., Feller E.R. Massive gastrointestinal bleeding as the initial manifestation of pancreatic carcinoma. Int. J. Pancreatol. 1994; 15 (3): 223-227.
11. Flati G., Salvatori F., Porowska B., Talarico C., Flati D., Proposito D., Talarico E., Carboni M. Severe hemorrhagic complications in pancreatitis. Ann. Ital. Chir. 1995; 66 (2): 233-237.
12. Jaeckle T., Stuber G., Hoffmann M.H., Jeltsch M., Schmitz B.L., Aschoff A.J. Detection and localization of acute upper and lower gastrointestinal (GI) bleeding with arterial phase multi-detector row helical CT. Eur. Radiol. 2008; 18 (7): 1406-1413. https://doi.org/10.1007/s00330-008-0907-z.
13. Yoon W., Jeong Y.Y., Shin S.S., Lim H.S., Song S.G., Jang N.G., Kim J.K., Kang H.K. Acute massive gastrointestinal bleeding: detection and localization with arterial phase multi-detector row helical CT. Radiology. 2006; 239 (1): 160-167. https://doi.org/10.1148/radiol.2383050175.
14. Kuhle W.G., Sheiman R.G. Detection of active colonic hemorrhage with use of helical CT: findings in a swine model. Radiology. 2003; 228 (3): 743-752. https://doi.org/10.1148/radiol.2283020756.
15. Lee E.W., Laberge J.M. Differential diagnosis of gastrointestinal bleeding. Tech. Vasc. Interv. Radiol. 2005; 7 (3): 112-122.
16. Vernava A.M. 3rd, Moore B.A., Longo W.E., Johnson F.E. Lower gastrointestinal bleeding. Dis. Colon Rectum. 1997; 40 (7): 846-858.
17. Rahn N.H. 3rd, Tishler J.M., Han S.Y., Russinovich N.A. Diagnostic and interventional angiography in acute gastrointestinal hemorrhage. Radiology. 1982; 143 (2): 361-366.
18. Baum S.T. Arteriographic diagnosis and treatment of gastrointestinal bleeding. In: Baum S.T., Pentecost M.J., eds. Abram’s angiography interventional radiology. 2nd ed. Philadelphia, Pa: Lippincott, Williams & Wilkins, 2006. 488 p.
Review
For citations:
Kochmashev I.V., Prudkov M.I., Mansurov Yu.V., Sherstobitov V.E., Shushanov A.P., Chernyshev S.D., Galimzyanov F.V. ENDOVASCULAR INTERVENTIONS FOR PANCREATIC BLEEDINGS. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2017;22(2):30-35. (In Russ.) https://doi.org/10.16931/1995-5464.2017230-35
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ISSN 1995-5464 (Print)
ISSN 2408-9524 (Online)
ISSN 2408-9524 (Online)
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