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Langenbecks Arch Surg. 2019 Mar;404(2):253-255. doi: 10.1007/s00423-019-01759-0. Epub 2019 Feb 13.

Management of post-pancreatectomy haemorrhage using resuscitative endovascular balloon occlusion of the aorta.

Author information

1
Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, Australia.
2
School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland.
3
Department of Vascular Surgery, Royal North Shore Hospital, Sydney, Australia.
4
Australian Pancreatic Centre, St Leonards, Sydney, Australia.
5
Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia.
6
Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia.
7
Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, Australia. jas.samra@bigpond.com.
8
Australian Pancreatic Centre, St Leonards, Sydney, Australia. jas.samra@bigpond.com.
9
Faculty of Medical and Health Sciences, Macquarie University, Sydney, Australia. jas.samra@bigpond.com.

Abstract

BACKGROUND:

Delayed massive post-pancreatectomy haemorrhage (PPH) is a highly lethal complication after pancreatectomy. Angiographic procedures have led to improved outcomes in the management of these patients. In the setting of an acute haemorrhage, laparotomy and packing are often required to help stablise the patient. However, re-operative surgery in the post-pancreatectomy setting is technically challenging.

METHODS:

A novel strategy of incorporating the resuscitative endovascular balloon occlusion of the aorta (REBOA) is described.

RESULTS:

Two patients where the specific application of this technique uses the REBOA were described.

CONCLUSION:

The REBOA serves as a useful adjunct in haemorrhage control and haemodynamic stablisation to allow successful management of delayed massive PPH.

KEYWORDS:

Bleeding; Complication; Fistula; Mortality; Pancreatectomy

PMID:
30758668
DOI:
10.1007/s00423-019-01759-0

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