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Management of post-pancreatectomy haemorrhage using resuscitative endovascular balloon occlusion of the aorta

  • Gurkirat Singh
  • Christopher B. Nahm
  • Nigel B. Jamieson
  • Terence C. Chua
  • Shen Wong
  • Cathy Thoo
  • Anubhav Mittal
  • Anthony J. Gill
  • Jaswinder S. SamraEmail author
How-I-Do-It article

Abstract

Background

Delayed massive post-pancreatectomy haemorrhage (PPH) is a highly lethal complication after pancreatectomy. Angiographic procedures have led to improved outcomes in the management of these patients. In the setting of an acute haemorrhage, laparotomy and packing are often required to help stablise the patient. However, re-operative surgery in the post-pancreatectomy setting is technically challenging.

Methods

A novel strategy of incorporating the resuscitative endovascular balloon occlusion of the aorta (REBOA) is described.

Results

Two patients where the specific application of this technique uses the REBOA were described.

Conclusion

The REBOA serves as a useful adjunct in haemorrhage control and haemodynamic stablisation to allow successful management of delayed massive PPH.

Keywords

Pancreatectomy Bleeding Complication Mortality Fistula 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human and animal rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards; informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Gurkirat Singh
    • 1
  • Christopher B. Nahm
    • 1
  • Nigel B. Jamieson
    • 1
    • 2
  • Terence C. Chua
    • 1
  • Shen Wong
    • 3
  • Cathy Thoo
    • 3
  • Anubhav Mittal
    • 1
    • 4
  • Anthony J. Gill
    • 6
    • 5
  • Jaswinder S. Samra
    • 1
    • 4
    • 7
    Email author
  1. 1.Upper Gastrointestinal Surgical UnitRoyal North Shore HospitalSydneyAustralia
  2. 2.School of Medicine, Dentistry and NursingUniversity of GlasgowGlasgowScotland
  3. 3.Department of Vascular SurgeryRoyal North Shore HospitalSydneyAustralia
  4. 4.Australian Pancreatic CentreSydneyAustralia
  5. 5.Department of Anatomical PathologyRoyal North Shore HospitalSydneyAustralia
  6. 6.Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical ResearchUniversity of SydneySydneyAustralia
  7. 7.Faculty of Medical and Health SciencesMacquarie UniversitySydneyAustralia

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