Delayed Massive Haemorrhage After Pancreatic Resection

Objective To explore the cause, treatment and prognosis of delayed massive haemorrhage (DMH) after pancreatic resection.Method Clinical data of1554patients undergoing pancreatectomy in our hospital from August2003to August2013were retrospectively analyzed.Results16patients suffered from DMH, including13patients who had undergone Postpancreaticoduodenectomy, and3patients who had resection of pancreatic body and tail. Gastrointestinal hemorrhage occurred in6patients, intra-abdominal hemorrhage occurred in10patients, respectively. Reoperations were performed in11patients, transcatheter arterial embolization(TAE) undertaken in2patients, and endoscopic treatment in3patients.10patients due to pancreatic leak, which corrodes blood vessels, and2patients because of gastrointestinal stress ulcer.10patients recovered after treatment,6patients (6/16) died. Continuous peritoneal perfusion after reoperation has lower mortality than conventional drainage after reoperation. Conclusions The mortality rate of DMH after pancreatic resection is high.Postoperative pancreatic leak and gastrointestinal stress ulcer are the most possible risk factors, intra-abdominal arterial hemorrhage is the main cause of death. Timely reoperation and continuous peritoneal perfusion is an effective method to management of DMH.