Risk factors and prevention strategies for intraperitoneal hemorrhage after pancreaticoduodenectomy
Journal Title: Journal of Surgery : Concepts & Practice - Year 2024, Vol 29, Issue 3
Abstract
[Objective] To investigate the risk factors and preventive strategies of pancreaticoduodenectomy postoperative hemorrhage. [Methods] A total of 208 patients who underwent pancreaticoduodenectomy in the Department of Hepatobiliary Surgery of the 904th Hospital of Joint Logistics Support Force, PLA from January 2017 to December 2021 were enrolled. Twenty-one patients with postoperative hemorrhage were retrospectively analyzed. [Results] Univariate analysis indicated that postoperative hemorrhage was mainly associated with pancreatic leakage, biliary leakage, abdominal infection, hypoproteinemia, diabetes, improper use of ultrasound knife, skeletonization, intraoperative blood loss, preoperative jaundice, etc.(P<0.05), but not gender and age (P>0.05). Among the 21 patients with postoperative hemorrhage, 4 cases recovered after conservative treatment such as hemostasis and blood transfusion, 6 cases underwent interventional treatment, 11 cases underwent abdominal exploration, and 2 cases died of postoperative multiple organ failure. Pancreatic leakage (OR=3.963,95%CI: 1.120-14.025), biliary leakage (OR=4.013,95% CI: 1.173-13.734) and abdominal infection (OR=7.545,95%CI: 1.833-31.051) were independent risk factors for postoperative hemorrhage. [Conclusions] The improvement of anastomotic manipulation, reduction of anastomotic leakage, and control and prevention of abdominal infection are important to prevent postoperative hemorrhage of pancreaticoduodenectomy. Surgical treatment should be performed as soon as possible for the patients with poor conservative treatment effect.
Authors and Affiliations
Wei LI, Sheng WU, Yujian TIAN, Xiaoming TANG, Chuang CAI, Zhiwei XU
Keywords
Related Articles
- EP ID EP750971
- DOI 10.16139/j.1007-9610.2024.03.10
- Views 35
- Downloads 1
Minimally invasive surgery facilitates surgical treatment of obesity and metabolic diseases
The prevalence and social burden of obesity and metabolic diseases are increasing. Multidisciplinary diagnosis and treatment, including surgical treatment, can effectively improve the condition of obesity and metabolic d...
Risk factors of postoperative delirium in elderly patients undergoing noncardiac surgery under general anesthesia
[Objective ] To investigate the incidence and related factors of postoperative delirium in elderly patients undergoing elective noncardiac surgery under general anesthesia. [Methods ] Elderly patients aged ≥65 years old...
Progress in research of the risk factors of lymph node metastasis in T1 stage colorectal cancer
Colorectal cancer is one of the common malignant tumors of the digestive tract. With the popularization of screening methods and advancement of endoscopic technology, an increasing number of T1 stage colorectal cancers c...
Vascular reconstruction in radical resection for hilar cholangiocarcinoma
Radical resection is the only option of curative treatment for hilar cholangiocarcinoma. Microscopically negative resection margin of bile duct (R0 resection) is critical for long-term survival of patients. However, both...
Perioperative application of geriatric nutritional risk index in senile patients with gastrointestinal tumors
[Objective] To study the value of perioperative application of geriatric nutritional risk index (GNRI) in elderly patients with gastrointestinal tumor. [Methods] GNRI or nutritional risk screening 2002 (NRS 2002) was use...