{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:14:52Z","timestamp":1762521292404,"version":"3.40.4"},"reference-count":19,"publisher":"S. Karger AG","issue":"4","license":[{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2009,1,1]],"date-time":"2009-01-01T00:00:00Z","timestamp":1230768000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dig Surg"],"published-print":{"date-parts":[[2009]]},"abstract":"<jats:p>&lt;i&gt;Background:&lt;\/i&gt; This study is to determine the risk factors and outcome for post-pancreaticoduodenectomy bleeding, and to assess the roles of surgery and intravascular intervention in its management. &lt;i&gt;Methods:&lt;\/i&gt; Post-pancreaticoduodenectomy data of 628 patients were analyzed with regards to post-pancreaticoduodenectomy bleeding. &lt;i&gt;Results:&lt;\/i&gt; Post-pancreaticoduodenectomy bleeding occurred in 58 patients (9.2%) and led to death in 23 patients. Pancreatic leakage and intra-abdominal abscess were independent risk factors for both extraluminal and intraluminal post-pancreaticoduodenectomy bleeding. The most common source of bleeding was the gastroduodenal artery (n = 9, 24.3%), and 8 of these patients (88.9%) experienced gastroduodenal artery bleeding in late post-pancreaticoduodenectomy bleeding. Hemostasis for post-pancreaticoduodenectomy bleeding was achieved by surgery in 22 patients (78.6%) and intravascular intervention in 7 patients (58.3%). Transarterial embolization for gastroduodenal artery bleeding did not deteriorate liver function in most patients except for 1 who died of hepatic failure. &lt;i&gt;Conclusions:&lt;\/i&gt; The placement of metallic clips on the gastroduodenal artery stump during a pancreaticoduodenectomy is helpful in identifying overlooked intermittent sentinel bleeding during angiography. Transarterial embolization for gastroduodenal artery bleeding could not guarantee against hepatic failure. The intravascular placement of a covered stent is the preferred procedure to avoid the complete interruption of arterial blood supply to the liver.<\/jats:p>","DOI":"10.1159\/000228245","type":"journal-article","created":{"date-parts":[[2009,7,10]],"date-time":"2009-07-10T12:23:05Z","timestamp":1247228585000},"page":"297-305","source":"Crossref","is-referenced-by-count":38,"title":["Risk Factors for Post-Pancreaticoduodenectomy Bleeding and Finding an Innovative Approach to Treatment"],"prefix":"10.1159","volume":"26","author":[{"given":"Hung-Kuang","family":"Wei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin-E","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Ming","family":"Shyr","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsiuo-Shan","family":"Tseng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan-Chen","family":"Tsai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tien-Hua","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheng-Hsi","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chew-Wun","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wing-Yiu","family":"Lui","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2009,7,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097%2F01.sla.0000262953.77735.db"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1001%2Farchsurg.133.10.1099"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1001%2Farchsurg.133.10.1094"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016%2FS1072-7515%2897%2900007-0"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.amjsurg.2006.12.034"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.jamcollsurg.2005.05.007"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1159%2F000064219"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.jamcollsurg.2006.01.020"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.amjsurg.2006.08.088"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1245%2Fs10434-007-9715-y"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00330-006-0359-2"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1159%2F000094750"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.surg.2007.02.001"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007%2Fs00268-003-6841-y"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016%2Fj.jamcollsurg.2004.04.005"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1159%2F000094754"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1002%2Fbjs.1800821124"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1445-1433.2004.03212.x"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1572-0241.2001.03691.x"}],"container-title":["Digestive Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/228245","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/228245","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T21:38:18Z","timestamp":1745444298000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000228245"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009]]},"references-count":19,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2009,10,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000228245","archive":["Portico"],"relation":{},"ISSN":["0253-4886","1421-9883"],"issn-type":[{"type":"print","value":"0253-4886"},{"type":"electronic","value":"1421-9883"}],"subject":[],"published":{"date-parts":[[2009]]}}}