The Role of Interventional Radiology in the Management of Late Postpancreaticoduodenectomy Hemorrhage

OBJECTIVE: To explore the role of interventional radiology (IR) in the management of late postpancreaticoduodenectomy hemorrhage (PPH). MATERIALS AND METHODS: Patients who had late PPH (occurring >24 h after index operation) managed by the IR procedure in our institution between 2013 and 2018 were retrospectively analyzed. RESULT: Hired patients who were diagnosed with grade B (n = 10) and C (n = 22) late PPH underwent 40 transcatheter arterial angiographies (TAA). The overall positive rate of angiography was 45.0% (18/40). Eighteen transcatheter arterial embolizations (TAEs) were performed, and the technical success rate was 88.89% (16/18). The rebleeding rate after embolization was 18.8% (3/16), and no severe procedure-related complications were recorded. The overall mortality of late PPH was 25.0% (8/32). CONCLUSION: Nearly half of hemorrhagic sites in late PPH could be identified by TAA. TAE is an effective and safe method for the hemostasia of late PPH in patients with positive angiography results.