Transcatheter Embolization of Celiac Artery Pseudoaneurysm following Pancreaticoduodenectomy for Pancreatic Cancer

Mori, Kensaku; Murata, Shigetoshi; Yoshioka, Hiroshi; Michishita, Nobunari; Kuramochi, Masayuki; Oda, Tatsuya; Saida, Yukihisa; Itai, Yuji

doi:10.3109/02841859809175498

Cited by 16 publications

(9 citation statements)

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“…The recommended intervention of this entity includes computed tomography scan,angiography which offers the option of embolization and three-dimensional angiographic imaging helical CT [15,31,32,33]. Transcatheter arterial embolization (TAE) has been efficacious for the treatment of pseudoaneurysms associated with pancreatitis [25, 34] and post-PD [11,35,36,37,38,39]. Emergency surgery for pseudoaneurysms is often hazardous and remains the solution to haemodynamically unstable patients and after failure of angiographic embolization [31].…”

Section: Discussionmentioning

confidence: 99%

Haemorrhage following Pancreaticoduodenectomy: Risk Factors and the Importance of Sentinel Bleed

Koukoutsis¹,

Bellagamba²,

Morris‐Stiff³

et al. 2006

Dig Surg

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Aim: To document the prevalence and to evaluate the management strategies of haemorrhagic complications following pancreaticoduodenectomy (PD). Methods: All patients who underwent PD from 1/2000 to 10/2005 and experienced at least one episode of haemorrhage during the 30 first days postoperatively were recorded. Etiology of haemorrhage, treatment strategy and mortality rate were recorded and analyzed. Results: A total of 362 patients underwent PD during this period and 32 (8.8%) had haemorrhage postoperatively of whom 15 died (47% mortality rate). Primary intraluminal haemorrhage was recorded in 13 patients, primary intra-abdominal haemorrhage in 5 patients and secondary haemorrhage in 14 patients. Successful management of haemorrhage with angioembilization occurred in 2 patients in the study group. Statistical analysis revealed sepsis and sentinel bleed as risk factors for post-PD haemorrhage and pancreatic leak and sentinel bleed as risk factors for secondary haemorrhage (p < 0.05). Conclusions: Haemorrhage after PD is a life-threatening complication. Sepsis, pancreatic leak, and sentinel bleed are statistical significant factors predicting post-PD haemorrhage. Sentinel bleed is not statistically significant associated with postoperative mortality, but with the onset of secondary haemorrhage. The effectiveness of therapeutic angioembolization was not demonstrated in our study.

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Section: Discussionmentioning

confidence: 99%

Haemorrhage following Pancreaticoduodenectomy: Risk Factors and the Importance of Sentinel Bleed

Koukoutsis¹,

Bellagamba²,

Morris‐Stiff³

et al. 2006

Dig Surg

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“…There are numerous case reports of hemobilia from cystic and right hepatic artery pseudoaneurysms formed as a complication of laparoscopic and open cholecystectomy [32][33][34][35][36][37][38][39][40][41][42]. Bile is thought to be irritating to vessel walls, delaying healing of damaged vessels at surgery and leading to pseudoaneurysm formation.…”

Section: Cholecystectomy and Other Surgerymentioning

confidence: 99%

“…Bile leak, biloma formation, and associated peritoneal infection are associated withand are a proposed mechanism for-pseudoaneurysm formation and hemobilia after cholecystectomy. Liver transplantation and pancreaticoduodenectomy (Whipple procedure) have also been reported to be complicated by hemobilia [32,[43][44][45][46][47]. Theoretically, the potential exists for hemobilia with any surgery of the hepatobiliary system.…”

Section: Cholecystectomy and Other Surgerymentioning

confidence: 99%

Hemobilia

Chin

Enns

2010

Curr Gastroenterol Rep

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Hemobilia is an uncommon medical problem that presents in a varied fashion and is increasingly of iatrogenic origin. The diagnosis of hemobilia needs to be considered in patients presenting with upper gastrointestinal bleeding, particularly if they are jaundiced with abdominal pain in the setting of recent or previous percutaneous liver intervention or abdominal trauma. Multislice computed tomographic angiography is increasingly being used in the investigation, but transcatheter arterial embolization remains the cornerstone of managing those patients requiring intervention. The majority of patients with hemobilia will be managed supportively or with radiologic intervention; most do not require surgical intervention.

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“…[3][4][5][6][7][8] We report the case of a patient in whom bleeding from a pseudoaneurysm of the enlarged dorsal pancreatic artery, caused by obstruction of the celiac axis, occurred after pancreatoduodenectomy.…”

mentioning

confidence: 98%

Pseudoaneurysm of the Dorsal Pancreatic Artery with Obstruction of the Celiac Axis After Pancreatoduodenectomy: Report of a Case

et al. 2005

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Pancreatoduodenectomy can be difficult in patients with obstruction of the celiac axis because of the development of collateral arteries around the head of the pancreas. Bleeding from a pseudoaneurysm is a rare and serious complication of pancreatoduodenectomy. We report a case of a pseudoaneurysm of an enlarged dorsal pancreatic artery, which formed as a result of obstruction of the celiac axis after pancreatoduodenectomy. We assumed that a weakness in the wall of this dorsal pancreatic artery caused by the dissection led to the formation of the aneurysm. Although transcatheter arterial embolization (TAE) could not treat the aneurysm or stop bleeding from the aneurysm completely, it achieved transient hemostasis, whereby the patient's condition improved, making laparotomy safe. This case demonstrates that the dissection of arteries that have developed around the head of the pancreas must be considered in patients with obstruction of the celiac axis.

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Transcatheter Embolization of Celiac Artery Pseudoaneurysm following Pancreaticoduodenectomy for Pancreatic Cancer

Cited by 16 publications

References 0 publications

Haemorrhage following Pancreaticoduodenectomy: Risk Factors and the Importance of Sentinel Bleed

Haemorrhage following Pancreaticoduodenectomy: Risk Factors and the Importance of Sentinel Bleed

Hemobilia

Pseudoaneurysm of the Dorsal Pancreatic Artery with Obstruction of the Celiac Axis After Pancreatoduodenectomy: Report of a Case

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