Nomogram for prediction of six-month mortality following endovascular treatment of delayed post-pancreatectomy hemorrhage

Figure 2 Endovascular management of post-pancreaticoduodenectomy arterial pseudoaneurysms. A and B: A 61-year-old male patient who underwent radical pancreaticoduodenectomy for bile duct cancer presented with acute hemorrhage from the gastroduodenal artery stump on postoperative day 27. Conventional hepatic angiography demonstrated a large pseudoaneurysm at the gastroduodenal artery stump with active contrast extravasation, associated with a drop in hemoglobin concentration (A); targeted embolization of the common hepatic artery achieved successful hemostasis (B); C and D: A 62-year-old male patient underwent radical pancreaticoduodenectomy combined with segmental resection of the transverse colon for a duodenal malignancy. Postoperatively, he developed intra-abdominal infection and presented with gastrointestinal bleeding on postoperative day 14, receiving both interventional treatment and laparotomy for debridement and drainage. The patient ultimately died from respiratory failure on postoperative day 77. Digital subtraction angiography revealed a pseudoaneurysm of the common hepatic artery (C); after placement of a covered stent in the common hepatic artery, follow-up angiography confirmed complete exclusion of the pseudoaneurysm while preserving distal hepatic arterial flow (D).