{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T14:07:45Z","timestamp":1790518065051,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,10,7]],"date-time":"2014-10-07T00:00:00Z","timestamp":1412640000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the causes, diagnosis and treatment of post\u2010pancreaticoduodenectomy hemorrhages (PPHs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A database of 703 pancreaticoduodenectomy patients in our institution (January 2008\u2013July 2013) was analyzed retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PPHs occurred in 62 patients of which, 38 had clear causes and 15 died because of uncontrolled bleeding and multiple organ failure. Pancreatic fistula and abdominal infection rates were significantly higher in the PPH group compared to the group who did not experience hemorrhages (<jats:italic>P<\/jats:italic> &lt; 0.05) but did not significantly increase the mortality of PPH patients. Hemostasis was attempted by endotherapy in 7 patients and was successful in 4 (57.1 %). Angioembolization was performed in 12 patients and was successful in 10 (83.3 %) and relaparotomy in 24 patients successful in 13 (54.2 %). All deceased patients belonged to International Study Group of Pancreatic Surgery clinical grade C and sentinel bleeding occurred in 60 % of PPH mortalities (9\/15) (<jats:italic>P<\/jats:italic> = 0.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pancreatic fistulae and abdominal infections are associated with PPH. Control of early mild upper gastrointestinal hemorrhages could be attempted by endotherapy, but angiography with intervention or surgical treatments were always required for delayed bleeding. The mortality in cases with sentinel bleedings was obviously increased.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2809-3","type":"journal-article","created":{"date-parts":[[2014,10,6]],"date-time":"2014-10-06T14:55:35Z","timestamp":1412607335000},"page":"509-515","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Diagnostic and Therapeutic Strategies to Manage Post\u2010Pancreaticoduodenectomy Hemorrhage"],"prefix":"10.1002","volume":"39","author":[{"given":"Jian\u2010feng","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery Chinese PLA General Hospital No 28 Fuxing Road 100853 Beijing China"},{"name":"Department of Hepatobiliary Surgery No. 401 Hospital of Chinese PLA No 22 Minjiang Road 266071 Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shi\u2010feng","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Chinese PLA General Hospital No 28 Fuxing Road 100853 Beijing China"},{"name":"Department of Hepatobiliary Surgery Shandong Provincial Hospital No 324 Jingwu Weiqi Road 250012 Jinan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Chinese PLA General Hospital No 28 Fuxing Road 100853 Beijing China"},{"name":"Department of Hepatobiliary Surgery Affiliated Hospital of Medical College Qingdao University No 16 Jiangsu Road 255000 Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan\u2010hu","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Chinese PLA General Hospital No 28 Fuxing Road 100853 Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery No. 401 Hospital of Chinese PLA No 22 Minjiang Road 266071 Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei\u2010sheng","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery No. 401 Hospital of Chinese PLA No 22 Minjiang Road 266071 Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Hong","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Chinese PLA General Hospital No 28 Fuxing Road 100853 Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,10,7]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.07.010"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2006.08.088"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000150169.22834.13"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000094754"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/13651820802247086"},{"key":"e_1_2_9_7_2","first-page":"220","article-title":"Late post pancreatectomy haemorrhage. 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