Management of post-pancreatectomy haemorrhage using resuscitative endovascular balloon occlusion of the aorta

Abstract

Background: Delayed massive post-pancreatectomy haemorrhage (PPH) is a highly lethal complication after pancreatectomy. Angiographic procedures have led to improved outcomes in the management of these patients. In the setting of an acute haemorrhage, laparotomy and packing are often required to help stablise the patient. However, re-operative surgery in the post-pancreatectomy setting is technically challenging. Methods: A novel strategy of incorporating the resuscitative endovascular balloon occlusion of the aorta (REBOA) is described. Results: Two patients where the specific application of this technique uses the REBOA were described. Conclusion: The REBOA serves as a useful adjunct in haemorrhage control and haemodynamic stablisation to allow successful management of delayed massive PPH.