Management of Delayed Postoperative Hemorrhage After Pancreaticoduodenectomy

Data Synthesis: One hundred sixty-three cases of DPH after pancreaticoduodenectomy were identified from the literature. The incidence of DPH after pancreaticoduodenectomy was 3.9%. Seventy-seven patients (47.2%) underwent LAP; 73 (44.8%), IR; and 13 (8%), conservative treatment.Onmeta-analysiscomparingLAPvsIRforDPH, no significant difference was found between the 2 treatmentoptionsforcompletehemostasis(73%vs76%;P=.23), mortality(43%vs20%;P=.14),ormorbidity(77%vs35%; P=.06). Conclusions:Thismeta-analysis,althoughbasedondata from small case series, is unable to demonstrate any significant difference between LAP and IR in the management of DPH after pancreaticoduodenectomy. The management of this life-threatening complication is difficult, and the appropriate treatment pathway ultimately will be decided by the clinical status of the patient and the institution preference.