Reevaluating Angiography in the Diagnosis and Management of Intraluminal Hemorrhage Following Pancreatoduodenectomy: Insights from 115 Cases Among 3,011 Surgeries

Intraluminal postpancreatoduodenectomy hemorrhage occurred in 3.8% of 3,011 patients, with a mortality rate of 6.1%.
More than a quarter of cases were “false” intraluminal hemorrhages due to primary extraluminal bleeding sources, with high BMI identified as an independent risk factor.
Angiography outperformed endoscopy and computed tomography in accurately localizing bleeding sources and had a lower false-positive rate than relaparotomy.
Definitive hemostasis rates following angiography were comparable to relaparotomy and superior to endoscopy, underscoring its therapeutic value.