Advances in the prevention and management of postoperative bleeding complications in pancreaticoduodenectomy: Current strategies and future directions precise

胰十二指肠切除术后出血并发症预防和处理的最新进展:当前策略和未来方向

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Abstract

Postoperative bleeding (POB) is a major complication following pancreaticoduodenectomy (PD), leading to significant morbidity and potential mortality. This minireview focuses on the prevention and management strategies for POB, synthesizing current evidence on surgical techniques, perioperative management, and postoperative interventions. Effective prevention strategies include the use of regional vessel wrapping, optimal pancreatic anastomosis, and meticulous intraoperative hemostasis. Postoperative management strategies, such as early detection using predictive models and advanced imaging, along with endovascular interventions like angiographic embolization and stent graft placement, are essential for timely intervention. Risk factors, including pancreatic texture, anticoagulation therapy, and patient comorbidities, further influence bleeding outcomes. The minireview also identifies gaps in current research and emphasizes the need for prospective randomized controlled trials to establish standardized protocols. Overall, a multidisciplinary approach combining surgical expertise, predictive analytics, and personalized care is essential to improving patient outcomes and minimizing the risk of POB following PD.

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