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Endovascular embolization for managing anastomotic bleeding after stapled digestive tract anastomosis.
- Source :
-
Acta radiologica (Stockholm, Sweden : 1987) [Acta Radiol] 2015 Nov; Vol. 56 (11), pp. 1368-72. Date of Electronic Publication: 2014 Nov 18. - Publication Year :
- 2015
-
Abstract
- Background: Anastomotic bleeding is an infrequent but life-threatening complication after stapled digestive tract anastomosis. Endovascular embolization is one of the available treatments, but precise clinical outcomes are yet to be evaluated.<br />Purpose: To evaluate the efficacy and safety of endovascular embolization for managing anastomotic bleeding after stapled digestive tract anastomosis.<br />Material and Methods: Twenty-eight patients were diagnosed with anastomotic bleeding after stapled digestive tract anastomosis by digital subtraction angiography (DSA). Curative effect was summed for analysis.<br />Results: All bleeding arteries were located in the stoma and were identified by contrast agent spillover by DSA. The offending arteries were superselectively catheterized and embolized with microcoils and/or gelatin sponge particles. Laboratory examinations showed normal hemoglobin and red blood cell counts when the patients' abdominal cavity drainage tubes stopped draining blood. The follow-up period was 3.2-84.7 months (median, 19.7 months). Four patients died during this time, of which two had cholangiocarcinoma, one had gastric cancer with tumor recurrence and multiple organ failure, and the final patient had a subarachnoid hemorrhage 4 months after embolization. In the surviving patients, no rebleeding occurred after embolization and no additional intervention or surgery was required.<br />Conclusion: Endovascular embolization is safe and effective for managing anastomotic bleeding after stapled digestive tract anastomosis.<br /> (© The Foundation Acta Radiologica 2014.)
- Subjects :
- Adolescent
Adult
Aged
Anastomotic Leak diagnostic imaging
Angiography, Digital Subtraction
Female
Gastrointestinal Hemorrhage diagnostic imaging
Humans
Male
Middle Aged
Postoperative Hemorrhage diagnostic imaging
Treatment Outcome
Anastomosis, Surgical methods
Anastomotic Leak therapy
Digestive System Surgical Procedures
Embolization, Therapeutic methods
Gastrointestinal Hemorrhage therapy
Postoperative Hemorrhage therapy
Surgical Stapling
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0455
- Volume :
- 56
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Acta radiologica (Stockholm, Sweden : 1987)
- Publication Type :
- Academic Journal
- Accession number :
- 25406432
- Full Text :
- https://doi.org/10.1177/0284185114556492