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| Timely synergic surgical and radiological aggressiveness improves perioperative mortality after hemorrhagic complication in Whipple procedure |
| Andrea Chierici a , Marcello Intotero b , Stefano Granieri a , Sissi Paleino a , Giovanni Flocchini a , Alessandro Germini a , Christian Cotsoglou a , ∗ |
a General Surgery Unit, University of Milan, ASST Vimercate, Via Santi Cosma e Damiano 16, 20871 Vimercate, Italy
b Radiodiagnostic Unit, ASST Vimercate, Via Santi Cosma e Damiano 16, 20871 Vimercate, Italy
∗ Corresponding author.
E-mail address: christian.cotsoglou@asst-vimercate.it (C. Cotsoglou). |
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Abstract Pancreaticoduodenectomy (PD) is a surgical procedure that exposes the patients to a wide range of postoperative complications that can also be lethal. Postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE) and postpancreatectomy hemorrhage (PPH) are among the most common. PPH has a lower incidence (3%−16%) [1] compared to POPF (3%−45%) [2] and DGE (19%−57%) [3], but it is burdened by a high mortality rate (16%−36%) [4,5]. The management of this complication is particularly demanding, and it needs the close cooperation of multidisciplinary teams: the pancreatic surgeon, the interventional radiologist, and the endoscopist. Although sometimes the severity of this condition seems overwhelming, the combination of multiple procedures can limit the morbidity and mortality related to PPH. The present study aimed to describe the postoperative course of a patient who underwent PD for periampullary adenocarcinoma at our institution and received three emergency laparotomies and three radiological procedures to successfully manage a grade C PPH.
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2021, Vol. 20 
