Hepatic artery reinforcement after post pancreatectomy haemorrhage caused by pancreatitis

Post-pancreatectomy hemorrhage (PPH) is a major complication occurring in 6–8% of patients after pancreaticoduodenectomy (PD) (1,2). Arterial bleeding is the most frequent cause. Mortality rate could reach 30% after grade C PPH according to ISGPS classification (1-3). Traditionally, a reoperation was performed but the emergence of interventional endovascular procedure has changed the PPH management. Complete interruption of hepatic arterial flow has to be a salvage procedure because of the high risk of intrahepatic abscess following the procedure. Surgical reoperation is still recommended in case of early postoperative bleeding or hemodynamic instability. Herein we report a technique to perform an artery reinforcement after PPH caused by pancreatitis