A case of stent-graft implantation for postpancreaticoduodenectomy hemorrhage in a patient with a reconstructed gastric tube

• Main Authors: Tomohiro Komada, MD, PhD, Yasushi Tachi, MD, PhD, Ken Nagasaka, MD, PhD, Suguru Yamada, MD, PhD, Masaya Matsushima, MD, PhD, Yutaro Sakaki, MD, Shinji Naganawa, MD, PhD
• Format: Article
• Language: English
• Published: Elsevier 2020-12-01
• Series: Radiology Case Reports
• Subjects: Stent-graft; Postoperative hemorrhage; Gastric tube; Pancreaticoduodenectomy
• Online Access: http://www.sciencedirect.com/science/article/pii/S1930043320305392

In patients with a reconstructed gastric tube, the right gastroepiploic artery is a very important feeding artery of the tube, which must be preserved when performing a pancreaticoduodenectomy. A 76-year-old man with a reconstructed gastric tube underwent pancreaticoduodenectomy for distal bile duct carcinoma. On postoperative day 8, he had an arterial hemorrhage from a drain, apparently from a ligation of the anterior superior duodenal artery. He, therefore, underwent stent-graft placement in the gastroduodenal artery. The stent-grafts were temporarily occluded, and the gastric tube was necrotizing. However, thrombolytic therapy allowed the stent-grafts to reopen and prevented gastric tube necrosis. We believe our case of stent-graft implantation in the gastroduodenal artery is the first of this kind to successfully prevent lethal necrosis of the gastric tube.