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

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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.

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Author information

Authors and Affiliations

  1. Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, Sydney, Australia

    Gurkirat Singh, Christopher B. Nahm, Nigel B. Jamieson, Terence C. Chua, Anubhav Mittal & Jaswinder S. Samra

  2. School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, Scotland

    Nigel B. Jamieson

  3. Department of Vascular Surgery, Royal North Shore Hospital, Sydney, Australia

    Shen Wong & Cathy Thoo

  4. Australian Pancreatic Centre, St Leonards, Sydney, Australia

    Anubhav Mittal & Jaswinder S. Samra

  5. Department of Anatomical Pathology, Royal North Shore Hospital, Sydney, NSW, Australia

    Anthony J. Gill

  6. Cancer Diagnosis and Pathology Research Group, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia

    Anthony J. Gill

  7. Faculty of Medical and Health Sciences, Macquarie University, Sydney, Australia

    Jaswinder S. Samra

Authors
  1. Gurkirat Singh
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  2. Christopher B. Nahm
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  3. Nigel B. Jamieson
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  4. Terence C. Chua
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  5. Shen Wong
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  6. Cathy Thoo
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  7. Anubhav Mittal
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  8. Anthony J. Gill
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  9. Jaswinder S. Samra
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Corresponding author

Correspondence to Jaswinder S. Samra.

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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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Singh, G., Nahm, C.B., Jamieson, N.B. et al. Management of post-pancreatectomy haemorrhage using resuscitative endovascular balloon occlusion of the aorta. Langenbecks Arch Surg 404, 253–255 (2019). https://doi.org/10.1007/s00423-019-01759-0

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  • DOI: https://doi.org/10.1007/s00423-019-01759-0

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