Contemporary Complication Rates and the Morbidity of Intervention

Pancreaticoduodenectomy (PD) performed for benign and malignant conditions can be complicated by delayed gastric emptying, anastomotic leaks, and postoperative pancreatic fistula, leading to significant morbidity. Though less common, postpancreatectomy hemorrhage (PPH) may occur in up to 16% of patients with an associated mortality nearing 40%. Preston et al present a large contemporary study on rates, etiology, and management of PPH from 2 high-volume pancreatic centers. Although 3% of the more than 3000 patients included had a PPH, only 16.7% were due to bleeding from the gastroduodenal artery (GDA). It is common practice to address the GDA with embolization or stent during interventional radiology procedures.