TY - JOUR
T1 - Endovascular management of bleeding events following robotic pancreaticobiliary surgery
AU - Gaba, Ron C.
AU - Khiatani, Vishal L.
AU - Knuttinen, M. Grace
AU - Omene, Benedictta O.
AU - Martinez, Brandon K.
AU - Bui, James T.
AU - Owens, Charles A.
PY - 2012/1
Y1 - 2012/1
N2 - 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.
AB - 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.
KW - Biliary tract
KW - Endovascular procedures
KW - Hemorrhage
KW - Pancreas
KW - Telerobotics
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U2 - 10.4261/1305-3825.DIR.4260-11.1
DO - 10.4261/1305-3825.DIR.4260-11.1
M3 - Article
C2 - 21948694
AN - SCOPUS:84855467591
SN - 1305-3825
VL - 18
SP - 121
EP - 126
JO - Diagnostic and Interventional Radiology
JF - Diagnostic and Interventional Radiology
IS - 1
ER -