Outcome of interventional radiology for delayed postoperative hemorrhage in hepatobiliary and pancreatic surgery
| Autor: | Eri Nakadai, Takashi Mishima, Satoshi Kuboki, Tsukasa Takayashiki, Shingo Kagawa, Shigetsugu Takano, Hideyuki Yoshitomi, Masayuki Ohtsuka, Daisuke Suzuki, Katsunori Furukawa, Nozomu Sakai |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Delayed Diagnosis Time Factors Digestive System Diseases Postoperative Hemorrhage Radiography Interventional Pancreatic surgery 03 medical and health sciences 0302 clinical medicine Pancreatectomy Medicine Humans Pancreatic resection Aged Retrospective Studies Aged 80 and over Hepatology medicine.diagnostic_test business.industry Mortality rate Gastroenterology Pancreatic Diseases Interventional radiology Middle Aged Hemostasis Surgical Surgery Hepatobiliary surgery Exact test Biliary Tract Surgical Procedures Treatment Outcome 030220 oncology & carcinogenesis Hemostasis 030211 gastroenterology & hepatology Female business Complication |
| Zdroj: | Journal of gastroenterology and hepatologyReferences. 35(12) |
| ISSN: | 1440-1746 |
| Popis: | Background and aim Postoperative hemorrhage is a rare but potentially lethal complication of hepatobiliary and pancreatic surgeries. This study aimed to retrospectively evaluate the clinical outcome of patients with delayed postoperative hemorrhage and compare the results according to the surgical procedure. Methods Overall, 4220 patients underwent surgery for hepatobiliary and pancreatic diseases. Delayed postoperative hemorrhage (observed more than 24 h postoperatively) occurred in 62 patients. Of these, 61 underwent interventional radiology to achieve hemostasis. Patients' clinical data were analyzed retrospectively. The chi-squared or Fisher's exact test was used in data analysis. Results A total of 62 patients (1.5%) developed delayed postoperative hemorrhage; 61 (1.4%) of them underwent interventional radiology to achieve hemostasis. Median duration from surgery to interventional radiology was 19 days (range: 5-252 days). Sentinel bleeding was detected in 31 patients; Clinical success was achieved in 54 patients (88.5%) by interventional radiology. Overall mortality rate was 26.2%. Causes of 16 in-hospital deaths were uncontrollable hemorrhage (n = 4) and worsening of general condition after hemostasis (n = 12). Mortality rates were 50.0% (11/22) and 12.8% (5/39) after hepatobiliary surgery and pancreatic resection, respectively. Mortality rate was significantly higher after hepatobiliary surgery than after pancreatic surgery (P = 0.002). Conclusions Interventional radiology can be successfully performed to achieve hemostasis for delayed hemorrhage after hepatobiliary and pancreatic surgeries. Because successful interventional radiology does not necessarily lead to survival, particularly after hepatobiliary surgery, meticulous attention to prevent surgical complications and intensive treatments before and after interventional radiology are required to improve outcomes. |
| Databáze: | OpenAIRE |
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