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Post-op Pancreatic Hemorrhage

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Textbook of Pancreatic Cancer

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Abstract

Postoperative pancreatic hemorrhage is a rare but severe complication, which accounts for nearly one-half of perioperative mortality and requires prompt recognition and adequate management. The International Study Group of Pancreatic Surgery (ISGPS) graded postpancreatectomy hemorrhage (PPH) in 2007 based on onset, location, and severity. Early hemorrhage is a result of insufficient hemostasis and is mostly treated by re-operation. An important warning sign for delayed hemorrhage is the “sentinel bleeding”, often associated with sepsis. The main cause of delayed hemorrhage is pseudoaneurysm. Patients should be first submitted to endovascular therapy and bleeding may be handled by applying coils or stent-grafting and complementarily by interventional drainage or surgery for the collection of infected fluid and for local sepsis control. Surgery may be challenging as a first choice therapy for late hemorrhage being a risk for new complications.

In general, outcome for postpancreatectomy bleeding seems to be better in high-volume hospitals and depends on early recognition and an adequately guided management.

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Authors and Affiliations

  1. Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany

    O. Radulova-Mauersberger, J. Weitz & M. Distler

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  1. O. Radulova-Mauersberger
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  2. J. Weitz
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  3. M. Distler
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Correspondence to M. Distler .

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Editors and Affiliations

  1. Stavanger University Hospital, The University of Bergen, Bergen, Norway

    Kjetil Søreide

  2. Chirurgie (VTT), Innsbruck Medical University, Innsbruck, Tirol, Austria

    Stefan Stättner

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Radulova-Mauersberger, O., Weitz, J., Distler, M. (2021). Post-op Pancreatic Hemorrhage. In: Søreide, K., Stättner, S. (eds) Textbook of Pancreatic Cancer. Springer, Cham. https://doi.org/10.1007/978-3-030-53786-9_67

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  • DOI: https://doi.org/10.1007/978-3-030-53786-9_67

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