Control of venous bleeding during dissection near the head of the pancreas

Abstract

Avulsion injury to portal vein tributaries can result in worrying haemorrhage during pancreatic gastric, and colonic resection. Attempts to control these avulsion injuries can result in extension of the tear into major portal vein tributaries. Pressure on the bleeding point tends to extend the laceration towards the portal vein, which bleeds torrentially when pressure is released for suturing. A technique is described to control the bleeding from these portal vein tributaries. This technique relies on adequate visualization and control of the torn ends of the portal vein tributaries thus enabling the surgeon to precisely suture the disrupted vessel without any collateral damage. This technique has been used on a number of occasions over the last decade with excellent results.