Risk Factors and Treatment for Hemorrhage after Pancreaticoduodenectomy: A Case Series of 423 Patients

Table 5

Nine postoperative deaths from PPH.

Case	Age/; gender	Primary disease	Pancreatic leakage	Bleeding time after surgery (h)	Bleeding type	Treatment approach	Source	Cause of death
1	38/M	Pancreatic ductal adenocarcinoma	No	7	Early intra-abdominal bleeding	Surgery	Section of residual uncinate process of pancreas	Rebleeding, MODS
2	42/M	Ampullary carcinoma	No	130	Late intra-abdominal bleeding	DSA, TAE, surgery	Mesenteric artery	Hepatic failure, renal failure
3	42/F	Cystadenocarcinoma of pancreas	Yes	118	Late intra-abdominal bleeding	DSA, TAE, surgery	Gastroduodenal artery	Rebleeding, MODS
4	54/M	Pancreatic ductal adenocarcinoma	Yes	152	Late intra-abdominal bleeding	DSA, surgery	Portal vein	Rebleeding, MODS
5	57/M	Distal bile duct carcinoma	Yes	126	Late intra-abdominal bleeding	DSA, TAE	Gastroduodenal artery	Hepatic failure
6	65/F	Distal bile duct carcinoma	Yes	134	Late intra-abdominal bleeding	DSA, TAE,; surgery	Gastroduodenal artery	Hepatic failure, renal failure
7	68/M	Cystadenocarcinoma of pancreas	Yes	142	Late intra-abdominal bleeding	DSA, surgery	Portal vein	Rebleeding, MODS
8	71/M	Ampullary carcinoma	Yes	128	Late gastrointestinal bleeding	Gastroscopy, DSA, TAE	Pancreaticojejunostomy anastomosis	Abdominal infection; MODS
9	72/M	Ampullary carcinoma	Yes	136	Late gastrointestinal bleeding	Gastroscopy, DSA	Unknown bleeding part	MODS

MODS: multiple organ dysfunction syndrome; DSA: digital subtraction angiography; TAE: transarterial embolization; M: male; F: female.