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Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review.

Mauri G, Mattiuz C, Sconfienza LM, Pedicini V, Poretti D, Melchiorre F, Rossi U, Lutman FR, Montorsi M - Insights Imaging (2014)

Bottom Line: Pancreatic resections are surgical procedures associated with high incidence of complications, with relevant morbidity and mortality even at high volume centres.This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications after pancreatic resection.A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussed.

View Article: PubMed Central - PubMed

Affiliation: Servizio di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy, vanni.mauri@gmail.com.

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 post-surgical 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 re-look surgery, shorter hospital stay and faster recovery. A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussed. Teaching Points • Interventional radiology is crucial to treat complications after pancreatic surgery • Percutaneous drainage of collections can be performed under ultrasound or computed tomography guidance • Percutaneous biliary procedures can be used to treat biliary complications • Venous procedures can be performed effectively through transhepatic or transjugular access • Fistulas can be treated effectively by percutaneous embolisation.

No MeSH data available.


Related in: MedlinePlus

Use of a percutaneous drainage to treat a post-pancreaticoduodenectomy fluid collection. a CT scan shows post-pancreaticoduodenectomy retroperitoneal fluid collection (asterisks). b The fluid collection (asterisks) is punctured with a small needle under CT guidance. c A percutaneous drainage (arrow) is inserted into the collection (asterisks) using the Seldinger technique. d At the end of the treatment complete resolution of the collection is obtained
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Fig1: Use of a percutaneous drainage to treat a post-pancreaticoduodenectomy fluid collection. a CT scan shows post-pancreaticoduodenectomy retroperitoneal fluid collection (asterisks). b The fluid collection (asterisks) is punctured with a small needle under CT guidance. c A percutaneous drainage (arrow) is inserted into the collection (asterisks) using the Seldinger technique. d At the end of the treatment complete resolution of the collection is obtained

Mentions: A case of a patient with fluid collection after pancreaticoduodenectomy successfully managed with percutaneous CT guided drainage is shown in Fig. 1.Fig. 1


Role of interventional radiology in the management of complications after pancreatic surgery: a pictorial review.

Mauri G, Mattiuz C, Sconfienza LM, Pedicini V, Poretti D, Melchiorre F, Rossi U, Lutman FR, Montorsi M - Insights Imaging (2014)

Use of a percutaneous drainage to treat a post-pancreaticoduodenectomy fluid collection. a CT scan shows post-pancreaticoduodenectomy retroperitoneal fluid collection (asterisks). b The fluid collection (asterisks) is punctured with a small needle under CT guidance. c A percutaneous drainage (arrow) is inserted into the collection (asterisks) using the Seldinger technique. d At the end of the treatment complete resolution of the collection is obtained
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4376815&req=5

Fig1: Use of a percutaneous drainage to treat a post-pancreaticoduodenectomy fluid collection. a CT scan shows post-pancreaticoduodenectomy retroperitoneal fluid collection (asterisks). b The fluid collection (asterisks) is punctured with a small needle under CT guidance. c A percutaneous drainage (arrow) is inserted into the collection (asterisks) using the Seldinger technique. d At the end of the treatment complete resolution of the collection is obtained
Mentions: A case of a patient with fluid collection after pancreaticoduodenectomy successfully managed with percutaneous CT guided drainage is shown in Fig. 1.Fig. 1

Bottom Line: Pancreatic resections are surgical procedures associated with high incidence of complications, with relevant morbidity and mortality even at high volume centres.This paper offers an overview on the interventional radiological procedures that can be performed to treat different type of complications after pancreatic resection.A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussed.

View Article: PubMed Central - PubMed

Affiliation: Servizio di Radiologia, IRCCS Policlinico San Donato, San Donato Milanese, Milano, Italy, vanni.mauri@gmail.com.

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 post-surgical 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 re-look surgery, shorter hospital stay and faster recovery. A selection of cases of complications following pancreatic surgery managed with interventional radiological procedure are presented and discussed. Teaching Points • Interventional radiology is crucial to treat complications after pancreatic surgery • Percutaneous drainage of collections can be performed under ultrasound or computed tomography guidance • Percutaneous biliary procedures can be used to treat biliary complications • Venous procedures can be performed effectively through transhepatic or transjugular access • Fistulas can be treated effectively by percutaneous embolisation.

No MeSH data available.


Related in: MedlinePlus