Diagnosis and treatment efficacy of digital subtraction angiography and transcatheter arterial embolization in post-pancreatectomy hemorrhage: A single center retrospective cohort study.

BACKGROUND: To evaluate the diagnostic and treatment efficacy of digital subtraction angiography (DSA), transcatheter arterial embolization (TAE) in post-pancreatectomy hemorrhage (PPH).

MATERIALS AND METHODS: This is a single-center retrospective cohort study. Clinicopathological data of 23 patients with PPH from August 2009 to November 2016 were collected. We observed (1) DSA procedures and hemorrhagic sites (2) TAE: successful rate and complications (3) Follow-up.

RESULTS: (1) 30 procedures of DSA were conducted in 23 patients, 20 (66.7%) procedures of contrast medium extravasation were observed. Among 20 procedures of positive DSA, hemorrhagic site located 5 times in gastroduodenal artery,4 times in common hepatic artery, 3 times in superior mesenteric artery, 3 times in splenic artery, 1 time in left gastric artery, right gastric artery, left hepatic artery, right hepatic artery and inferior mesenteric artery respectively. (2) Besides 4 failure procedures of TAE managed by surgery, 16 procedures of TAE were conducted, with 14 successful hemostasis. 2 procedures of post-TAE re-hemorrhage were managed by surgery. In 9 patients with 10 procedures of negative DSA, 9 had conservative treatment and 1 was managed by surgery. (3) 6 patients died because of the metastasis, median survival time was 7.5 months.

CONCLUSIONS: DSA is minimal invasive in the diagnosis of PPH, and TAE is safe and effective for patients with positive DSA.