Evidence-based management of hemorrhage after pancreaticoduodenectomy

• Published in: The American journal of surgery Vol. 194; no. 1; pp. 10 - 12
• Main Author: Ellison, Edwin Christopher, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-07-2007; Elsevier; Elsevier Limited
• Subjects: Abdomen; Biological and medical sciences; Failure; General aspects; Hemorrhage; Humans; Medical imaging; Medical sciences; Mortality; Pancreaticoduodenectomy - adverse effects; Postoperative Hemorrhage - etiology; Postoperative Hemorrhage - therapy; Reoperation; Reporting requirements; Stomach, duodenum, intestine, rectum, anus; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Time Factors; Tomography; Veins & arteries; Clinical management; Treatment; Duodenum; Surgery; Pancreas; Hemorrhage; Evidence-based medicine; Pancreatoduodenectomy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2006.12.034

Other definitions have been employed: (1) Tien et al [2] defined massive postoperative bleeding as the need for relaparotomy or transcatheter embolization to stop the bleeding; (2) Choi et al [3] defined delayed hemorrhage as bleeding from the surgical site requiring greater than 2 units of packed red cells, surgical intensive care unit supervision, laparotomy, or transarterial embolization 5 days or more after pancreaticoduodenectomy; (3) de Castro et al [4] defined this complication as postoperative bleeding occurring 24 hours after the index operation requiring a transfusion need of at least 4 units; and (4) Koukoutsis et al [5] defined massive hemorrhage as a drop in arterial pressure of 40 mm Hg or more and the administration of at least 2 units of blood during resuscitation. First bleeding may be gastrointestinal, also termed intraluminal or intra-abdominal.