Journal Article

Clinical Features and Treatment Outcomes of Pseudoaneurysm Following Pancreatic Resection

Toru, Ikegami, Shuichi, Fujioka, Yukio, Nakabayashi, Shinji, Onda, Takeyuki, Misawa, Teruyuki, Usuba, Tomoyoshi, Okamoto, Yasuro, Futagawa

2022

Overview

Management strategies for pseudoaneurysm rupture after pancreatic resection have not yet been firmly established due to its low incidence and effects of environmental variability among centers. This study aimed to provide a basis for treatment strategy improvement. Clinical features and outcomes of 29 patients who experienced pseudoaneurysm formation or rupture following pancreatic resection were retrospectively reviewed. The incidence of pseudoaneurysm formation was 2.8%. In 28 of 29 patients, pseudoaneurysm was identified via emergent dynamic computed tomography (CT). The rates of complete cessation of bleeding by interventional radiology (IVR) and surgical intervention were 88% and 100%, respectively. Mortality rate was 13.8%. Four patients treated by IVR died, including three of massive bleeding and one of liver failure. Patients with suspected pseudoaneurysm rupture after pancreatic resection should undergo immediate CT. Open surgery is preferable for patients with incomplete hemostasis by IVR or those who cannot immediately undergo IVR, however, IVR is an effective alternative.

• Publisher: Anticancer Research USA Inc,International Institute of Anticancer Research
• Subject: Abdomen / Abscesses / Adult / Aged / Aged, 80 and over / Aneurysm, False / Aneurysm, False - diagnostic imaging / Aneurysm, False - etiology / Aneurysm, False - mortality / Aneurysm, False - therapy / Aneurysm, Ruptured / Aneurysm, Ruptured - diagnostic imaging / Aneurysm, Ruptured - etiology / Aneurysm, Ruptured - mortality / Aneurysm, Ruptured - therapy / Bleeding / Blood Vessel Prosthesis / Blood Vessel Prosthesis Implantation / Blood Vessel Prosthesis Implantation - adverse effects / Blood Vessel Prosthesis Implantation - instrumentation / Blood Vessel Prosthesis Implantation - mortality / Cancer therapies / Computed tomography / Embolization / Embolization, Therapeutic / Embolization, Therapeutic - adverse effects / Embolization, Therapeutic - instrumentation / Embolization, Therapeutic - mortality / Endovascular Procedures / Endovascular Procedures - adverse effects / Endovascular Procedures - instrumentation / Endovascular Procedures - mortality / Environmental effects / Female / Fistula / Hematoma / Hemostasis / Hemostatics / Humans / Intervention / Liver failure / Male / Medical imaging / Middle Aged / Mortality / Pancreas / Pancreatectomy / Pancreatectomy - adverse effects / Pancreatic cancer / Pancreatic Neoplasms / Pancreatic Neoplasms - surgery / Pancreaticoduodenectomy / Pancreaticoduodenectomy - adverse effects / Patients / Pseudoaneurysm / Radiography, Interventional / Radiology / Retrospective Studies / Rupture / Stents / Success / Surgery / Surgical anastomosis / Time Factors / Tokyo / Tomography, X-Ray Computed / Treatment Outcome / Tumors / Veins & arteries