TY - JOUR
T1 - Role of interventional radiology in the management of complications after pancreaticoduodenectomy
AU - Baker, Todd A.
AU - Aaron, Joshua M.
AU - Borge, Marc
AU - Pierce, Kenneth
AU - Shoup, Margo
AU - Aranha, Gerard V.
PY - 2008/3/1
Y1 - 2008/3/1
N2 - Background: This study evaluated the role of interventional radiology (IR) procedures to manage complications after pancreaticoduodenectomy. Methods: A retrospective review was made of the records of patients with postsurgical complications managed with IR. Results: Among the 440 patients reviewed, the mortality, morbidity and reoperation rates were 1.6%, 36%, and 2%, respectively. Complications occurred in 159 patients, of which 39 (25%) required ≥1 IR procedures. Of those 39 patients, 72% underwent percutaneous drainage of an intra-abdominal abscess, 18% underwent percutaneous biliary drainage, and 10% underwent angiography for gastrointestinal bleeding or pseudoaneurysm. The reoperation rate among the 159 patients with complications was 6% (n = 9). Reoperation was avoided in 90% of patients receiving IR. Four patients underwent reoperation despite IR for persistent abscess, pancreatic fistula, anastomotic disruption, or mesenteric venous bleeding. Conclusions: The majority of complications occurring after pancreaticoduodenectomy can be managed effectively using IR, thus minimizing morbidity and the need for reoperation.
AB - Background: This study evaluated the role of interventional radiology (IR) procedures to manage complications after pancreaticoduodenectomy. Methods: A retrospective review was made of the records of patients with postsurgical complications managed with IR. Results: Among the 440 patients reviewed, the mortality, morbidity and reoperation rates were 1.6%, 36%, and 2%, respectively. Complications occurred in 159 patients, of which 39 (25%) required ≥1 IR procedures. Of those 39 patients, 72% underwent percutaneous drainage of an intra-abdominal abscess, 18% underwent percutaneous biliary drainage, and 10% underwent angiography for gastrointestinal bleeding or pseudoaneurysm. The reoperation rate among the 159 patients with complications was 6% (n = 9). Reoperation was avoided in 90% of patients receiving IR. Four patients underwent reoperation despite IR for persistent abscess, pancreatic fistula, anastomotic disruption, or mesenteric venous bleeding. Conclusions: The majority of complications occurring after pancreaticoduodenectomy can be managed effectively using IR, thus minimizing morbidity and the need for reoperation.
KW - Bile leak
KW - Complication
KW - Interventional radiology
KW - Intra-abdominal abscess
KW - Pancreatic fistula
KW - Pancreaticoduodenectomy
KW - Percutaneous
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U2 - 10.1016/j.amjsurg.2007.12.026
DO - 10.1016/j.amjsurg.2007.12.026
M3 - Article
C2 - 18308043
AN - SCOPUS:40749121297
VL - 195
SP - 386
EP - 390
JO - American Journal of Surgery
JF - American Journal of Surgery
SN - 0002-9610
IS - 3
ER -