Role of interventional radiology in the management

Authors: Giovanni Mauri Chiara Mattiuz Luca Maria Sconfienza Vittorio Pedicini Dario Poretti Fabio Melchiorre Umberto Rossi Fabio Romano Lutman Marco Montorsi

Publish Date: 2014/12/17

Volume: 6, Issue: 2, Pages: 231-239

PDF Link

Abstract

Pancreatic resections are surgical procedures associated with high incidence of complications with relevant morbidity and mortality even at high volume centres A multidisciplinary approach is essential in the management of these events and interventional radiology plays a crucial role in the treatment of patients developing postsurgical complications This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications after pancreatic resection Procedures such as percutaneous drainage of fluid collections percutaneous transhepatic biliary procedures arterial embolisation venous interventions and fistula embolisation are viable treatment options with fewer complications compared with relook surgery shorter hospital stay and faster recovery A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussedPancreatic resection is a surgical procedure associated with significant morbidity and mortality even at specialised highvolume centres 1 2 3 Although in recent years refinements in surgical technique and perioperative management have led to a reduction in perioperative mortality the incidence of postoperative complications including intraabdominal abscesses and leakages 4 5 6 7 8 9 biliary complications 10 11 12 13 14 and vascular complications 15 16 17 18 still remains high Moreover in case of complications surgical reoperation is associated with a high mortality rate 1 2 3 In a large series of 650 patients Yeo et al 2 reported an overall mortality of 14  and a morbidity of 41  with a mean length of hospital stay of 13 days They reported reoperation in 26/650 patients 4  and identified the absence of reoperation as an independent predictor of prolonged survival 2

Keywords: