Arterial pseudoaneurysms following hepato-pancreato-biliary surgery: a single center experience.

Context: Arterial pseudoaneurysm is an uncommon lethal complication following hepato-pancreato-biliary surgery.

Objective: Aim of this study is to present and discuss the experience of a high volume oncological center.

Methods: Since 2007 all major surgeries performed at Sanchinarro Oncological Center have been included in a prospective database looking for postoperative arterial pseudonaurysm.

Results: Until June 2014, among 559 hepato-pancreato-biliary procedures, a total of 14 arterial pseudoaneurysms have been identified (2.5%). Sentinel bleeding was in 57% of cases. Failed arterial embolization occurred in 2 cases. Overall mortality rate was 28.5%. We also identified 3 asymptomatic pseudoaneurysms, one of them managed without embolization, developing a sudden bleeding and died after surgery.

Conclusions: According to our experience, pseudoaneurysm incidence is higher than reported in current literature and it can be successfully managed through arterial embolization. Furthermore, we found 3 asymptomatic pseudoaneurysms, whose management is still controversial.