Abstract:

Hemorrhage is a threatening complication after pancreatic surgery, which severely affects the life of patients due to rapid onset and difficult diagnosis. According to different types of diseases, the sites and approaches of pancreatic surgery, and the causes of postoperative pancreatic hemorrhage (PPH) significantly differ. With the improvement of surgical methods and rapid development of interventional techniques, surgeons have more options to treat postoperative bleeding. Corresponding measures should be taken to manage perioperative bleeding for pancreatic surgery. The diagnosis should be made based on laboratory and imaging examinations. Preoperative reduction of jaundice, transfusion of frozen plasma, platelets and vitamin K can be performed to improve coagulation function. Precise intraoperative operation can avoid vascular injury. Appropriate suturing, bandage and sealer should be adopted to achieve precise hemostasis. Postoperatively, the drainage tube should be maintained patent to avoid abdominal infection caused by delayed detection of bleeding or poor drainage of pancreatic fistula. Abdominal ultrasound and CT scan should be performed timely to identify pancreatic fistula and deliver drainage treatment. Extensive attention should be diverted to the phenomenon of sentinel bleeding. Effective measures should be taken to reduce the occurrence of PPH. In this article, the definition, causes, diagnosis and treatment of PPH were reviewed, aiming to provide further reference for clinical practice.

Key words: Post-pancreatectomy hemorrhage, Digestive endoscopy, Interventional operation, Pancreaticoduodenectomy, Pancreatojejunostomy, Total pancreatectomy, Laparotomy hemostasis