Clnical Analysis Of Hemorrhage After Pancreaticoduodenectomy

【Objective】 Analysis pancreaticoduodenectomy postoperative abdominal andgastrointestinal bleeding risk factors, to explore the causes of bleeding and treatmentstrategies to improve the clinicians and the diagnosis and treatment of the diseaseoccurs.【Methods】 Retrospective analysis of the line in the Fujian Provincial Hospitalfrom May2009to May2013pancreaticoduodenectomy152cases ofpancreaticoduodenectomy patients with clinical data, analyze the causes of bleedingand treatment strategies.【Results】152patients,83males (54.6%), female to male69cases (45.4%) aged25to73years, with an average age of55.39years, non-bleeding after group of134cases, the bleeding group,18patients, the incidence of11.8%. Uppergastrointestinal bleeding in7cases (4.61%), intra-abdominal hemorrhage in7cases(4.61%), upper gastrointestinal bleeding in4patients (2.63%) with abdominal.Univariate analysis showed that: intra-abdominal complications include pancreaticfistula, biliary fistula, intra-abdominal infection and anastomotic leakage,Pancreaticojejunostomy way statistically significant (P <0.05). Multivariateanalysis results show that: pancreatic fistula, anastomotic fistula and anastomosis isan independent risk factor for postoperative bleeding, OR values were4.187;5.480;3.018.【Conclusion】 Pancreatic fistula, anastomotic fistula, the way ofPancreaticojejunostomy is an independent risk factor for pancreaticoduodenectomypostoperative bleeding, threatened hemorrhage predict the PPH important signs,angiography is early diagnosis and improve the treatment success rate method,clinicians should pay attention to the pseudoaneurysm rupture caused bypostoperative bleeding. Improve the perioperative management, active prevention,timely detection and treatment of postoperative abdominal complications can reducethe incidence of postoperative bleeding.