Clinical Analysis of 61 Patients with Postoperative Hemorrhage after Abdominal Surgery: A Single-center Retrospective Study

  Objective  The aim of this study was to explore the causes of postoperative rebleeding after abdominal surgery and the timing of intervention, so as to optimize the treatment plan.

  Methods  The clinical data of patients with abdominal bleeding after abdominal surgery from January 2013 to December 2018 were retrospectively collected in Peking Union Medical College Hospital. The causes of bleeding, treatment plan, and prognosis were analyzed.

  Results  A total of 61 patients with postoperative hemorrhage after abdominal surgery who met the inclusion and exclusion criteria were enrolled in this study, including 49 males and 12 females. Among them, most patients had pancreaticoduodenectomy (50.8%, 31/61), followed by liver surgery (16.39%, 10/61) and gastric surgery (14.8%, 9/61). The causes of bleeding were identified in 56 patients, including 24 cases of wound bleeding and/or arteriolar active bleeding (42.9%, 24/56) and 11 cases of anastomotic bleeding (19.6%, 11/56). After hemorrhage, most patients (65.6%, 40/61) underwent surgical hemostasis, with a success rate of 87.50%; hemostasis by interventional embolization was adopted in the other patients(24.6%, 15/61), with a success rate of 26.7%(P > 0.01). Successful hemostasis was achieved in 55 cases. Five cases died, and one gave up treatment.

  Conclusions  Major abdominal surgery increases hemorrhage risk. Hemostasis of surgery may be superior to that of interventional embolization.