Original communicationPostpancreatectomy hemorrhage (PPH)–An International Study Group of Pancreatic Surgery (ISGPS) definition
Section snippets
Methods
The consensus definition in this manuscript was developed by the International Study Group of Pancreatic Surgery (ISGPS), which was founded in the spring of 2006. All participating surgeons are specialists from high-volume centers with long-term experience in pancreatic surgery and scientific research. An extensive Medline search was performed to identify the existing literature on definitions of postoperative hemorrhage after pancreatic resection. All available major publications from the past
Terminology
For the purposes of the definition and this paper, “pancreatic surgery” includes the following procedures: pylorus-preserving or classical pancreaticoduodenectomy, pancreatic left resection, duodenum-preserving pancreatic head resection, pancreatic segment resection, or total pancreatectomy. The terms used most commonly to identify this complication (postoperative hemorrhage after pancreatic resection) were as follows: intraabdominal or gastrointestinal hemorrhage; early or delayed
Discussion
Unlike for other complications after pancreatic surgery, such as postoperative pancreatic fistula,11 an internationally accepted, objective definition is lacking for PPH. Previously reported “definitions” of postoperative hemorrhage vary widely and are heterogeneous regarding time of onset, grade, severity, and clinical impact.
A clear, objective differentiation into early and late hemorrhage will allow further analysis and comparison of causes of PPH, such as a direct failure of intraoperative
References (37)
- et al.
Risk factors of massive bleeding related to pancreatic leak after pancreaticoduodenectomy
J Am Coll Surg
(2005) - et al.
Postoperative pancreatic fistula: an international study group (ISGPF) definition
Surgery
(2005) - et al.
Gastrointestinal bleeding after operation for pancreatic cancer
Am J Surg
(1983) - et al.
Management of delayed visceral arterial bleeding after pancreatic head resection
J Gastrointest Surg
(2005) Management of complications following pancreaticoduodenectomy
Surg Clin North Am
(1995)- et al.
Management of bleeding and leakage after pancreatic surgery
Best Pract Res Clin Gastroenterol
(2004) - et al.
Delayed hemorrhage after pancreaticoduodenectomy
J Am Coll Surg
(2004) - et al.
Life-threatening upper gastrointestinal tract bleeding caused by ruptured extrahepatic pseudoaneurysm after pancreatoduodenectomy
Surgery
(1998) - et al.
Pancreatic anastomotic leak after pancreaticoduodenectomy: incidence, significance, and management
Am J Surg
(1994) - et al.
Interventional radiology for management of celiac trunk bleeding after pancreatic surgery
J Am Coll Surg
(2006)
Delayed massive haemorrhage after pancreatic and biliary surgery
Br J Surg
Standards for pancreatic resection in the 1990s
Arch Surg
Ten-year experience with 733 pancreatic resections: changing indications, older patients, and decreasing length of hospitalization
Arch Surg
Delayed massive hemorrhage after pancreatic and biliary surgery: embolization or surgery?
Ann Surg
Complications following pancreaticoduodenectomyCurrent management
Arch Surg
The complications of pancreatectomy
Ann Surg
Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes
Ann Surg
An analysis of the reduced morbidity and mortality rates after pancreaticoduodenectomy
Arch Surg
Cited by (0)
- ⁎
The first two authors contributed equally to this publication.