Management of XXXX after pancreatoduodenectomy.

@entity1 @entity834 @entity548 @entity86 @entity2849
BACKGROUND/AIMS: @entity548 after pancreatoduodenectomy is a severe, life-threatening complication. This study was conducted to determine the guidelines appropriate for the prevention and management of @entity548 . METHODOLOGY: We reviewed the medical records of 456 @entity1 who had undergone pancreatoduodenectomy at our hospital between 1991 and 2000. RESULTS: Significant @entity86 occurred in 21 @entity1 (4.6%). Early @entity548 (within the 5th postoperative day) caused by improper intraoperative hemostasis occurred in 5 of these cases; 3 of whom were saved by prompt operation and one by conservative management. The other 16 cases consisted of late @entity548 (after the 5th postoperative day), of which 12 @entity1 (75%) experienced pancreatic leaks and 8 @entity2849 of major arteries. "Sentinel @entity548 " was evident in 8 cases. Angiographic embolization was performed in 8 cases, 7 of which were successful. Reoperation was tried in 7 cases with complete hemostasis being achieved in 2. As a result, 15 of 21 @entity1 obtained complete hemostasis and the mortality rate from @entity548 was 28.6% (6/21). CONCLUSIONS: Rapid decision-making is mandatory when @entity548 stigmata such as @entity2849 on CT and sentinel @entity548 are noted. Prompt operation for early @entity548 and angiographic embolization for late @entity548 are recommended. In order to prevent @entity548 after pancreatoduodenectomy, meticulously performed hemostasis and the avoidance of pancreatic @entity834 are essential.
