Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review

Mauri, Giovanni; Mattiuz, Chiara; Sconfienza, Luca Maria; Pedicini, Vittorio; Poretti, Dario; Melchiorre, Fabio; Rossi, Umberto; Lutman, Fabio Romano; Montorsi, Marco

doi:10.1007/s13244-014-0372-y

Cited by 30 publications

(29 citation statements)

References 34 publications

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“…When the patient is hemodynamically stable, it's generally recommended to perform abdominal and pelvic multidetector computer tomography (MDCT) angiography as soon as sentinel bleeding is observed, when sensitivity is highest (12,22,29,37,38). MDCT angiography can show the cause, nature and site of bleeding, being a fundamental tool as it can avoid or guide treatment (10,15,(39)(40)(41). Nonetheless, even if MDCT is performed, a clear bleeding site cannot be identified in many cases (1).…”

Section: Clinical Manifestation Diagnosis and Managementmentioning

confidence: 99%

“…Permanent embolisation is reached using non-resorbable materials that induce a permanent vessel occlusion. To date, there is no consensus regarding an ideal embolizing agent; nevertheless, every case may need a specific embolic agent and the prompt availability of the material is required into any angio suite (41). The list of embolic materials includes polyvinyl alcohol, bucrilate, metallic coils or detachable balloons.…”

Section: Techniques and Scenariosmentioning

confidence: 99%

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Bleeding complications after pancreatic surgery: interventional radiology management

2019

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Surgical intervention in the pancreas region is complex and carries the risk of complications, also of vascular nature. Bleeding after pancreatic surgery is rare but characterized by high mortality. This review reports epidemiology, classification, diagnosis and treatment strategies of hemorrhage occurring after pancreatic surgery, focusing on the techniques, roles and outcomes of interventional radiology (IR) in this setting. We then describe the roles and techniques of IR in the treatment of other less common types of vascular complications after pancreatic surgery, such as portal vein (PV) stenosis, portal hypertension and bleeding of varices.

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Section: Clinical Manifestation Diagnosis and Managementmentioning

confidence: 99%

Section: Techniques and Scenariosmentioning

confidence: 99%

Bleeding complications after pancreatic surgery: interventional radiology management

2019

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“…The recent years brought developments in the conservative treatment methods of the early phase of AP [20][21][22][23][24][25][26][27], particularly in the first week of illness, when the mortality is mostly connected to organ failure [20,25,28]. In our study, comparing the early phase of the study (2007-2011) with the late phase (2012-2016) a shorter duration of hospitalization and a lower mortality rate were documented in the later phase of the study.…”

Section: Discussionmentioning

confidence: 50%

Clinical and epidemiological aspects of acute pancreatitis - 10 years of single-center experience

Jagielski¹,

Kijowski²,

Fruczek³

et al. 2019

Eur J Trans Clin Med

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Background: We can observe an increase in acute pancreatitis (AP) incidence in the recent years. Materials and methods: Retrospective clinical data analysis of 370 patients with AP, hospitalized between 2007 and 2016 at our Department. Results: AP was diagnosed during 406 hospitalisation in 370 patients [average age 52.15 (21-93), 237(64.05%) male]. AP of high clinical severity was diagnosed in 60/370 (16.22%) patients. Average time of hospitalisation was 16.13 (1-121) days. Mortality was 12/406 (2.96%). The after effect of AP in form of parapancreatic fluid reservoirs was diagnosed in 202/406 (54.59%) cases. Comparing the early phase of the study (2007-2011) and the later one (2012-2016) a shorter time of hospitalisation was proven and a lower mortality of the patients in the later phase of the study. Analysis of patients' blood tests revealed that patients with severe AP have significantly elevated levels of inflammatory parameters and amylase comparing to group with mild and moderate AP, during the first days of hospitalisation. Conclusion: The development of conservative treatment options for AP, especially in early stages of the illness, has significantly shortened the duration of hospitalisation of patients with AP at our Department.

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“…Other interventional radiology vascular procedures include stent grafting, which can be able to preserve the blood flow, as well as the use of side-hole catheters in tortuous vessels, for which the side holes remain in the aorta (18,19). We consider that these procedures would be more suited in such cases than ours for all the above-mentioned reasons.…”

Section: Discussionmentioning

confidence: 93%

A Rare Case of Walled-off Pancreatic Necrosis Complicated by Splenic Artery Rupture Manifested After Surgical Internal Drainage - Diagnostic and Therapeutic Aspects

Șurlin¹,

Marinescu²,

Ionescu³

et al. 2018

chr

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Large walled-off pancreatic necrosis (WON) is a well-known complication of severe acute pancreatitis, and it is associated with significant morbidity and mortality. This is the case report of a rare and potentially fatal complication of WON - a delayed splenic artery rupture close to its origin after surgical drainage. A 44-year old male patient admitted in our Surgical Department and diagnosed with WON evolving without infection for 6 months, after an episode of acute pancreatitis, underwent a Rouxen- Y WON-jejunostomy. In the 4th postoperative day patient presented melenic stools and a selective celiac trunk angiography was performed with the suspicion of a bleeding from the WON. At the initial injection of contrast a small leakage of contrast was observed but did not reappear despite repeated injection. The procedure was aborted, and the patient put under close observation. The 6th postoperative day bleeding re-occurred, and the angiography indicated a breach in the splenic artery. As the patient developed hemodynamic instability in the Radiology Department he was immediately transferred into the operating room and an exploratory laparotomy with suture of the splenic artery was performed. The patient had an uneventful recovery and at one-year follow-up was without any particular problems.

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Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review

Cited by 30 publications

References 34 publications

Bleeding complications after pancreatic surgery: interventional radiology management

Bleeding complications after pancreatic surgery: interventional radiology management

Clinical and epidemiological aspects of acute pancreatitis - 10 years of single-center experience

A Rare Case of Walled-off Pancreatic Necrosis Complicated by Splenic Artery Rupture Manifested After Surgical Internal Drainage - Diagnostic and Therapeutic Aspects

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