Aortic occlusion balloon catheter technique is useful for uncontrollable massive intraabdominal bleeding after hepato-pancreato-biliary surgery.
Massive intraabdominal hemorrhage sometimes requires urgent hemostatic surgical intervention. In such cases, its rapid stabilization is crucial to reestablish a general hemodynamic status. We used an aortic occlusion balloon catheter in patients with massive intraabdominal hemorrhage occurring after hepato-pancreato-biliary surgery. An 8-French balloon catheter was percutaneously inserted into the aorta from the femoral artery, and the balloon was placed just above the celiac artery. Fifteen minutes inflation and 5 minutes deflation were alternated during surgery until the bleeding was surgically controlled. An aortic occlusion balloon catheter was inserted on 13 occasions in 10 patients undergoing laparotomy for hemostasis of massive hemorrhage. The aorta was successfully occluded on 12 occasions in nine patients. Both systolic pressure and heart rate were normalized during aortic occlusion, and the operative field became clearly visible after adequate suction of leaked blood. Bleeding sites were then easily found and controlled. Hemorrhage was successfully controlled in 7 of 10 patients (70%), and they were discharged in good condition. The aortic occlusion balloon catheter technique was effective for easily controlling massive intraabdominal bleeding by hemostatic procedure after hepato-pancreato-biliary surgery.
Miura
Fumihiko
F
Department of Surgery, Teikyo University, School of Medicine, Tokyo, Japan.
Takada
Tadahiro
T
Ochiai
Takenori
T
Asano
Takehide
T
Kenmochi
Takashi
T
Amano
Hodaka
H
Yoshida
Masahiro
M
D000005:Abdomen; D000368:Aged; D001012:Aorta, Abdominal; D021721:Balloon Occlusion / Q000295:instrumentation; D017734:Bile Ducts, Extrahepatic / Q000601:surgery; D016063:Blood Loss, Surgical; D001794:Blood Pressure / Q000502:physiology; D002445:Celiac Artery; D013505:Digestive System Surgical Procedures; D005260:Female; D005263:Femoral Artery; D006339:Heart Rate / Q000502:physiology; D006488:Hemostasis, Surgical / Q000379:methods; D006489:Hemostatic Techniques / Q000295:instrumentation; D006498:Hepatectomy; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D016577:Pancreaticoduodenectomy; D019106:Postoperative Hemorrhage / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate