Clinical surgery—internationalRisk factors for and management of delayed intraperitoneal hemorrhage after pancreatic and biliary surgery
Section snippets
Patient characteristics
Sixty-nine patients with an American Society of Anesthesia physical status I and II who underwent pancreatic and biliary surgery with skeletonization for lymphadenectomy of major vessels on the hepatoduodenal ligament in the Department of Surgery at Oita Red Cross Hospital between April 2002 and March 2005 were entered into this trial. All patients were diagnosed preoperatively as having a malignant neoplasm at the pancreatic head and extrahepatic biliary regions, therefore, skeletonization for
Patients who failed to have complications
One or more significant complications occurred in 30 patients (43.5%). The most frequent complication was intraperitoneal abscess (39.1%), followed by wound infection (24.6%). Bile leakage occurred in 4 patients (5.7%), and pancreatic fistula occurred in 9 patients (13%). DIH occurred in 4 patients (5.8%) within a median of 15 days (range, 7–32 d). We experienced 4 postoperative mortalities (5.7%), and 3 of these were a result of postoperative liver failure after hepatopancreaticoduodenectomy
Comments
DIH after pancreatic and biliary surgery is one of the major complications along with pancreatic fistula, bile leakage, intra-abdominal abscess, and delayed gastric empting [1], [2], [3], [4], [5], [6]. In particular, the mortality rate associated with this complication is high, ranging from 14% to 38% [6], [11], [16], [17]. However, in our study, the mortality rate of DIH was zero. TAE was performed successfully in the major arterial system, including the common hepatic artery, without liver
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2017, PancreatologyCitation Excerpt :The incidence of VTE in patients who have undergone pancreatic surgery is considered highest in those with HBP malignancies [1,12,13]C:∖GetARef∖Refs∖enoxaparin.ref #25;. In addition, postoperative bleeding complications are still an important cause of postoperative mortality in patients undergoing pancreatic surgery [11,14–16]. Several studies of postoperative thromboprophylaxis with enoxaparin in patients who underwent HBP surgery, especially major hepatectomy, have been performed [12,17].
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