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Purposes <p>Endovascular management of post-pancreatectomy hemorrhage (PPH) is widely accepted as a less invasive alternative to relaparotomy. This study aimed to evaluate the efficacy and safety of stent graft placement compared with transarterial embolization (TAE) for treating extraluminal PPH.</p> Methods <p>Among 741 patients who underwent pancreatectomy at our institution between 2005 and 2025, 45 (6.1%) developed extraluminal PPH requiring hemostatic intervention and were included in this retrospective analysis. The clinical outcomes following stent graft placement were compared with those following TAE.</p> Results <p>Ten patients underwent stent graft placement, 30 underwent TAE, and two underwent laparotomy after unsuccessful TAE. Hemostasis was successfully achieved in all patients treated with stent grafts, with preservation of the arterial blood flow. Among patients with extraluminal PPH involving the hepatic artery (<i>n</i> = 23), post-treatment hepatic infarction or abscess formation occurred significantly more frequently in the TAE group (7/14) than in the stent graft group (0/9) (<i>p</i> = 0.046). Although stent patency declined over time, intrahepatic arterial perfusion was preserved in all patients, despite stent occlusion.</p> Conclusions <p>Stent graft placement for extraluminal PPH may be superior to TAE in preventing hepatic infarction and abscess formation while maintaining hepatic arterial perfusion.</p>

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Is stent graft placement superior to transarterial embolization in the treatment of patients with extraluminal post-pancreatectomy hemorrhage?

  • 期刊论文

  • 发表日期：

    2026年7月29日

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  • Yuki Hisano,
  • Hirohisa Okabe,
  • Hiromitsu Hayashi,
  • Katsuhiro Ogawa,
  • Shota Uemura,
  • Shinsei Yumoto,
  • Takashi Matsumoto,
  • Daisuke Ogawa,
  • Yuki Adachi,
  • Takuya Tajiri,
  • Takanobu Yamao,
  • Rumi Itoyama,
  • Yuki Kitano,
  • Tatsunori Miyata,
  • Yoshitaka Tamura,
  • Toshinori Hirai,
  • Masaaki Iwatsuki

摘要

Purposes

Endovascular management of post-pancreatectomy hemorrhage (PPH) is widely accepted as a less invasive alternative to relaparotomy. This study aimed to evaluate the efficacy and safety of stent graft placement compared with transarterial embolization (TAE) for treating extraluminal PPH.

Methods

Among 741 patients who underwent pancreatectomy at our institution between 2005 and 2025, 45 (6.1%) developed extraluminal PPH requiring hemostatic intervention and were included in this retrospective analysis. The clinical outcomes following stent graft placement were compared with those following TAE.

Results

Ten patients underwent stent graft placement, 30 underwent TAE, and two underwent laparotomy after unsuccessful TAE. Hemostasis was successfully achieved in all patients treated with stent grafts, with preservation of the arterial blood flow. Among patients with extraluminal PPH involving the hepatic artery (n = 23), post-treatment hepatic infarction or abscess formation occurred significantly more frequently in the TAE group (7/14) than in the stent graft group (0/9) (p = 0.046). Although stent patency declined over time, intrahepatic arterial perfusion was preserved in all patients, despite stent occlusion.

Conclusions

Stent graft placement for extraluminal PPH may be superior to TAE in preventing hepatic infarction and abscess formation while maintaining hepatic arterial perfusion.