{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:52:28Z","timestamp":1790614348937,"version":"4.1.0"},"reference-count":31,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,12,18]],"date-time":"2018-12-18T00:00:00Z","timestamp":1545091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Clinical Research Award of the First Affiliated Hospital of Xi\u2019an Jiaotong University, China","award":["XJTU1AF-CRF-2017-004"],"award-info":[{"award-number":["XJTU1AF-CRF-2017-004"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Post\u2010pancreaticoduodenectomy hemorrhage (PPH) is a potentially lethal complication. The objective of this study was to explore the risk factors of PPH and to evaluate the treatment options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical data of 739 consecutive patients undergoing pancreaticoduodenectomy between 2009 and 2017 were collected from a prospectively maintained database. Univariate and multivariate analysis was performed by logistic regression model to evaluate potential risk factors associated with early and late PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The morbidity of PPH was 8.7% (64\/739), while the mortality was 12.5% (8\/64). Twenty\u2010two (34.4%) patients developed PPH within postoperative day 1 (early PPH) whereas 42 (65.6%) patients after postoperative day 1 (late PPH). No significant risk factor was identified associated with early PPH, whereas pancreatic duct diameter &lt;\u00a00.4\u00a0cm, and intra\u2010abdominal complications, such as pancreatic fistula, intra\u2010abdominal abscess, and delayed gastric emptying, were independently correlated with late PPH. There were 10 (15.6%) grade A, 28 (43.8%) grade B, and 26 (40.6%) grade C bleedings. The bleeding sites were verified by endoscopy, angiography, and\/or exploratory laparotomy in 23 of 54 (42.6%) patients with grade B or C hemorrhage. Seven out of nine (78%) patients with arterial bleeding were cured by angiography and embolization, while 10 of 11 (90.9%) patients with anastomotic, venous, or retroperitoneum bleeding were rescued by laparotomy. Ten patients with grade A and 22 patients with grade B or C hemorrhage were treated successfully by blood transfusion and hemostatic medications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hemorrhage following pancreaticoduodenectomy is a common and lethal complication. Treatment strategies should be tailored according to different etiologies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.14560","type":"journal-article","created":{"date-parts":[[2018,12,4]],"date-time":"2018-12-04T12:38:54Z","timestamp":1543927134000},"page":"1100-1107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Intra\u2010abdominal hemorrhage following 739 consecutive pancreaticoduodenectomy: Risk factors and treatments"],"prefix":"10.1111","volume":"34","author":[{"given":"Jian\u2010Wen","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi China"},{"name":"Institute of Advanced Surgical Technology and Engineering The First Affiliated Hospital of Xi'an Jiaotong University  Xi'an Shaanxi 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