Copyright
©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Fatal arterial hemorrhage after pancreaticoduodenectomy: How do we simultaneously accomplish complete hemostasis and hepatic arterial flow?
Yasuyuki Kamada, Tomohide Hori, Hidekazu Yamamoto, Hideki Harada, Michihiro Yamamoto, Masahiro Yamada, Takefumi Yazawa, Ben Sasaki, Masaki Tani, Asahi Sato, Hikotaro Katsura, Ryotaro Tani, Ryuhei Aoyama, Yudai Sasaki, Masaharu Okada, Masazumi Zaima
Yasuyuki Kamada, Tomohide Hori, Hidekazu Yamamoto, Hideki Harada, Michihiro Yamamoto, Masahiro Yamada, Takefumi Yazawa, Ben Sasaki, Masaki Tani, Asahi Sato, Hikotaro Katsura, Ryotaro Tani, Ryuhei Aoyama, Yudai Sasaki, Masazumi Zaima, Department of Surgery, Shiga General Hospital, Moriyama 524-8524, Shiga, Japan
Masaharu Okada, Department of Cardiovascular Medicine, Shiga General Hospital, Moriyama 524-8524, Shiga, Japan
Author contributions: Kamada Y collected the data; Kamada Y and Hori T analyzed the data, reviewed the published literature and wrote the manuscript; Kamada Y and Hori T contributed equally to this work; all authors discussed therapeutic options, reviewed previous papers, and provided important opinions; Zaima M and Hori T supervised this report.
Institutional review board statement: This report was approved by the Institutional Review Board of Shiga General Hospital, Moriyama, Japan.
Informed consent statement: The patients involved in this study provided written informed consent authorizing the use and disclosure of their protected health information.
Conflict-of-interest statement: None of the authors have any financial conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
http://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Tomohide Hori, FACS, MD, PhD, Associate producer, Surgeon, Department of Surgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama 524-8524, Shiga, Japan. horitomo55office@yahoo.co.jp
Received: February 3, 2021
Peer-review started: February 3, 2021
First decision: March 1, 2021
Revised: March 7, 2021
Accepted: March 19, 2021
Article in press: March 19, 2021
Published online: April 27, 2021
ARTICLE HIGHLIGHTS
Research background
Arterial hemorrhage after pancreaticoduodenectomy (PD) is fatal.
Research motivation
This hemorrhage is caused by pseudoaneurysm rupture, and the gastroduodenal artery stump and hepatic artery are frequent culprit vessels.
Research objectives
Simultaneous accomplishment of complete hemostasis and hepatic artery flow preservation is difficult after PD. Although complete hemostasis may be obtained by transcatheter arterial embolization or surgery, liver infarction and/or abscesses may occur.
Research methods
Arterial hemorrhage after PD is fatal. This hemorrhage is caused by pseudoaneurysm.
Research results
We here evaluate our experience including actual treatments (transcatheter arterial embolization, stent-graft placement, or surgery), and discuss therapeutic strategies.
Research conclusions
Transcatheter placement of a covered stent is useful for simultaneous accomplishment of complete hemostasis and hepatic arterial flow preservation.
Research perspectives
Therapeutic options for fatal arterial hemorrhage after PD is shown.
