Analysis Of Therapeutics For Postoperative Hemorrhage After Pancreatoduodenectomy

Objective:To summarize our experience in the diagnosis and treatment ofPostoperative hemorrhage after pancreaticoduodenectomy and improve clinical treatmentmeasures. Methods:The medical records of246patients who had undergonepancreaticoduodenectomy in the First Affiliated Hospital of Xinjiang MedicalUniversity between January2002and January2013were analyzed retrospectively withregard to postoperative intraabdominal hemorrhage. Results:Twenty-nine patients withhemorrhage after pancreaticoduodenectomy were screened and the incidence of11.79%(29/246).Gastrointestinal hemorrhage accounted for48.28%(14/29), abdominalhemorrhage accounted for51.72%(15/29).Conservative treatment in10cases,1death;operative (including interventional therapy and open surgery treatment) in19cases,9death. The success rate of Conservative to gastrointestinal hemorrhage Group andabdominal hemorrhage group were57.14%(8/14) and13.33%(2/15) between the twogastrointestinal hemorrhage conservative success rate than intraperitoneal hemorrhageconservative group (P=0.02);gastrointestinal hemorrhage group and intra-abdominalhemorrhage group reoperation rate were42.86%(6/14) and86.67%(13/15) afterconservative treatment fails, both intraperitoneal hemorrhage conservative failed surgicalintervention was significantly higher than the group of gastrointestinal hemorrhage(P=0.02);gastrointestinal hemorrhage group and intra-abdominal hemorrhage mortality was21.43%and53.33%respectively, between the two abdominal hemorrhage mortality washigher than the group of gastrointestinal hemorrhage, but the difference was notstatistically significant (P=0.5). The interventional therapy group11cases, open surgerygroup,8cases of rebleeding number of cases were6cases and3cases (P=0.65), the deadwere3cases and6cases (P=0.07).Conclusion:Most of the postoperative hemorrhageafter pancreatoduodenectomy was severe, and we can cured most of the Gastrointestinal hemorrhage through conservative treatment. Bu the abdominal hemorrhage need thesurgery treatment (intervention or laparotomy) and the abdominal hemorrhage’ fatalityrate is higher than gastrointestinal hemorrhage.We may reduce the mortality rate if wetake active individualized treatment measures such as surgical exploration,interventional therapy in full consideration of the patient’s bleeding site, bleeding volume,possible causes bleeding and the patient’s hemodynamic circumstances.