Wang Q, Liu GG, Pan F, Xu JY, Jiao Y, Liu Q, Liu YH. Advances in the prevention and management of postoperative bleeding complications in pancreaticoduodenectomy: Current strategies and future directions precise. World J Clin Oncol 2025; 16(8): 108928 [DOI: 10.5306/wjco.v16.i8.108928]
Corresponding Author of This Article
Ya-Hui Liu, PhD, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Xinmin Street, Changchun 130021, Jilin Province, China. yahui@jlu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Clin Oncol. Aug 24, 2025; 16(8): 108928 Published online Aug 24, 2025. doi: 10.5306/wjco.v16.i8.108928
Advances in the prevention and management of postoperative bleeding complications in pancreaticoduodenectomy: Current strategies and future directions precise
Qian Wang, Geng-Geng Liu, Feng Pan, Jia-Yi Xu, Yan Jiao, Qing Liu, Ya-Hui Liu
Qian Wang, Jia-Yi Xu, Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China
Geng-Geng Liu, Science and Technology Information of Jilin Province, Changchun 130000, Jilin Province, China
Feng Pan, Department of Radiologic Imaging, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China
Yan Jiao, Ya-Hui Liu, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Qing Liu, Department of Endocrinology and Metabolism, China-Japan Union Hospital of Jilin University, Changchun 130000, Jilin Province, China
Co-corresponding authors: Qing Liu and Ya-Hui Liu.
Author contributions: Wang Q and Liu YH designed the overall concept and outline of the manuscript; Pan F and Xu JY contributed to the discussion and design of the manuscript; Jiao Y and Liu Q contributed to the writing, and editing the manuscript, illustrations, and review of literature; Liu Q and Liu YH have played important and indispensable roles in the manuscript preparation as the co-corresponding authors; all authors have read and approved the final manuscript.
Conflict-of-interest statement: The authors claim no conflicts.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ya-Hui Liu, PhD, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Xinmin Street, Changchun 130021, Jilin Province, China. yahui@jlu.edu.cn
Received: April 27, 2025 Revised: May 20, 2025 Accepted: July 22, 2025 Published online: August 24, 2025 Processing time: 116 Days and 21.8 Hours
Abstract
Postoperative bleeding (POB) is a major complication following pancreaticoduodenectomy (PD), leading to significant morbidity and potential mortality. This minireview focuses on the prevention and management strategies for POB, synthesizing current evidence on surgical techniques, perioperative management, and postoperative interventions. Effective prevention strategies include the use of regional vessel wrapping, optimal pancreatic anastomosis, and meticulous intraoperative hemostasis. Postoperative management strategies, such as early detection using predictive models and advanced imaging, along with endovascular interventions like angiographic embolization and stent graft placement, are essential for timely intervention. Risk factors, including pancreatic texture, anticoagulation therapy, and patient comorbidities, further influence bleeding outcomes. The minireview also identifies gaps in current research and emphasizes the need for prospective randomized controlled trials to establish standardized protocols. Overall, a multidisciplinary approach combining surgical expertise, predictive analytics, and personalized care is essential to improving patient outcomes and minimizing the risk of POB following PD.
Core Tip: Postoperative bleeding remains a life-threatening complication following pancreaticoduodenectomy (PD). This minireview highlights the latest evidence on prevention strategies, such as regional vessel wrapping and optimal pancreatic anastomosis, as well as effective management techniques, including predictive models, endovascular interventions, and early detection. Addressing patient-specific risk factors, such as pancreatic texture and anticoagulation therapy, is crucial for minimizing bleeding risks. Further research through prospective randomized controlled trials is necessary to refine these strategies and improve outcomes for PD patients.
