THREE CASES OF MASSIVE INTRAPERITONEAL BLEEDING FOLLOWING PANCREATIC FISTULA AS POSTOPERATIVE COMPLICATION OF TOTAL GASTRECTOMY WITH DISTAL PANCREATECTOMY

Pancreatic fistula following total gastrectomy with distal pancreatectomy can cause massive intraperitoneal bleeding from the the exposed main vessels. It is known as a fatal postoperative complication. We here report three cases of postoperative intraperitoneal massive bleeding due to pancreatic fistual.These three patients underwent distal pancreatectomy with total gastrectomy for a gastric cancer. Pancreatic fustula occurred postoperatively in all three cases, leading to massive intraperitoneal bleeding. Emergency operation for hemostasis was successfully carried out in all cases. In addition, we used an occlusion balloon catheter in order to control the bleeding from the abdominal aorta with a favorable outcome. We consider that this catheter is quite effective against excessive intraperitoneal bleeding, because it reduced a loss of blood and maintained the hemodynamic state.