A case of successful transarterial stenting for pseudoaneurysm after pancreaticoduodenectomy

Abstract

Postpancreaticoduodenectomy (PD) bleeding, which is reported to occur in 5-7%, is a major complication that often causes life-threatening secondary events. A transarterial catheter technique with coil embolization is a widespread procedure that could potentially cause massive hepatic infarction and subsequent sepsis with hepatic abscess, which can be a fatal complication. Here, we introduce a new transarterial technique that uses a hemostat with a stent graft, which successfully rescued a patient had suffered post-PD bleeding.

Keywords: Subtotal Stomach‐Preserving Pancreaticoduodenectomy (SSPPD); post‐pancreaticoduodenectomy bleeding; transarterial stenting.

Figure 1

Digital subtraction angiography at sentinel bleeding and stenting for the gastroduodenal artery. (a) A small aneurysm was noted at GDA stump (arrow). (b) A stent graft, 5 mm in diameter and 2.5 cm in length, was placed in the CHA (arrowheads). CHA, common hepatic artery; GDA, gastroduodenal artery.

Figure 2

Digital subtraction angiography at sentinel bleeding and stenting for the right hepatic artery replaced on the superior mesenteric artery. (a) A small aneurysm was noted at RHA replaced on SMA (arrow). (b) A stent graft, 5 mm in diameter and 5 cm in length, was placed in the RHA (arrowheads). RHA, right hepatic artery; SMA, superior mesenteric artery.