Open AccessFatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic arterial flow?
Author(s) -
Yasuyuki Kamada,
Tomohide Hori,
Hidekazu Yamamoto,
Hideki Harada,
Masafumi Yamamoto,
Masahiro Yamada,
Takefumi Yazawa,
Ben Sasaki,
Masaki Tani,
Satoru Asahi,
Hikotaro Katsura,
Ryouji Tani,
Ryuhei Aoyama,
Y. Sasaki,
Masaharu Okada,
Masazumi Zaima
Publication year - 2021
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v13.i4.483
Subject(s) - medicine , pancreaticoduodenectomy , hemostasis , cardiology , pancreas
Although arterial hemorrhage after pancreaticoduodenectomy (PD) is not frequent, it is fatal. Arterial hemorrhage is caused by pseudoaneurysm rupture, and the gastroduodenal artery stump and hepatic artery (HA) are frequent culprit vessels. Diagnostic procedures and imaging modalities are associated with certain difficulties. Simultaneous accomplishment of complete hemostasis and HA flow preservation is difficult after PD. Although complete hemostasis may be obtained by endovascular treatment (EVT) or surgery, liver infarction caused by hepatic ischemia and/or liver abscesses caused by biliary ischemia may occur. We herein discuss therapeutic options for fatal arterial hemorrhage after PD.