Diagnostic and Interventional Radiology
Interventional Radiology - Original Article

Endovascular management of bleeding events following robotic pancreaticobiliary surgery

1.

Department of Radiology, University of Illinois Hospital and Health Sciences System, Chicago, Illinois, USA

2.

Department of Radiology, University of Illinois at Chicago, Chicago, IL, USA

Diagn Interv Radiol 2012; 18: 121-126
DOI: 10.4261/1305-3825.DIR.4260-11.1
Read: 413 Downloads: 240 Published: 03 September 2019

Abstract

PURPOSE
To describe the utility, safety, and efficacy of endovascular intervention for treating bleeding events after robotic pancreaticobiliary surgery.

 

MATERIALS AND METHODS
In this retrospective study, six patients (male/female, 3/3; mean age, 64 years) with histories of robotic pancreaticobiliary resection were referred for endovascular management of delayed postoperative intra-abdominal hemorrhage. Visceral angiography was performed, and the sites of suspected arterial hemorrhage were interrogated with selective microcatheter arteriography. The visualized bleeding sources were treated using catheter-directed embolotherapy with metallic coils, bare metal or covered stent insertion, or a combination of the two. The measured outcomes included the technical success of the angiographic occlusion, procedure safety, and procedure efficacy.

 

RESULTS
Pseudoaneurysms resulted in bleeding in six cases (100%). The endovascular interventions included coil embolization in three cases (50%), covered stent exclusion in two cases (33%), and bare metal stent-assisted coil embolization in one case (17%). The technical success was 100%, with complete cessation of bleeding in all cases. No immediate or delayed procedure-related complications were encountered in any of the patients. The efficacy of the endovascular therapy was 100% in this series, with no recurrent hemorrhage during the mean clinical follow-up period of 262 days (range, 67–446 days).

 

CONCLUSION
Endovascular therapy provides a minimally invasive, safe, and effective method for managing hemorrhagic events after complicated pancreaticobiliary surgery.

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EISSN 1305-3612