PDF icon Download PDF
Open Access
CC BY 4.0 · Journal of Clinical Interventional Radiology ISVIR 2025; 09(02): 90-100
DOI: 10.1055/s-0045-1808066
Original Article

Impact of Interventional Radiology in Modern-Day Pancreatic Surgery

Suyash Kulkarni
1   Department of Radio-Diagnosis, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
,
Nitin S. Shetty
2   Department of Radiodiagnosis, ACTREC - TMC, Kharghar, Maharashtra, India
,
David Narayan Rameswarapu 
3   Department of Interventional Radiology, Christian Medical College, Vellore, Tamil Nadu, India
,
Kunal Gala
4   Department of Radio-Diagnosis, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
,
Shailesh V. Shrikhande
5   Department of Surgical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
,
Vikram Choudhary
5   Department of Surgical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
,
Manish Bhandare
5   Department of Surgical Oncology, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India
› Author Affiliations
Funding None.
› Further Information
Also available ateRefMedOne
  Permissions and Reprints
Preview

Abstract

Purpose

To evaluate the role of interventional radiology (IR) in modern-day pancreatic surgery.

Methods

Study design: An audit of prospectively maintained electronic medical records.

Duration of study: All patients who required image-guided interventions for postpancreatectomy complications from January 2014 to December 2019 were identified and reviewed.

Results

Among 758 patients who underwent pancreatectomy, 206 (27.2%) developed complications. Of these, 46 patients (6%) experienced postpancreatectomy hemorrhage (PPH), with 30 patients (3.96%) requiring intervention; 13 patients (43.3%) underwent angioembolization, of whom 5 (38.46%) died due to causes unrelated to PPH, while 17 patients (56.7%) underwent surgical re-exploration. Although the 90-day mortality rates were not statistically significant, they appeared to be higher in the endovascular group (38.46 vs. 17.6%). Intra-abdominal fluid collections were observed in 173 patients (22.8%), with 147 (85%) undergoing image-guided interventions and 23 (13.3%) undergoing surgical re-exploration. The 90-day mortality rates were 6.12 and 21.7% in the IR and surgical groups, respectively. Biliary complications occurred in 31 patients (4%), of which 18 (58%) underwent image-guided intervention and 11 (35.5%) underwent surgical re-exploration. The 90-day mortality rates were 27.78 and 35.5% in the IR and surgical groups, respectively. Image-guided interventions successfully prevented re-exploration in 61.5% of PPH cases, 88.9% of biliary complications, and 99.3% of intra-abdominal fluid collections.

Conclusion

IR procedures are safe and effective, and the synergistic role of the interventional radiologist provides a minimally invasive approach in the management of postpancreatectomy complications while reducing the need for re-exploration, thereby reducing the recovery time and preventing morbidity associated with re-exploration.

Keywords

postpancreatectomy complications - interventional radiology - image-guided interventions

Ethical Approval

For this type of study, formal consent is not required. The study was performed after approval from the Institutional Ethics Committee.


Informed Consent

For this type of study, informed consent is not required.




Publication History

Article published online:
01 May 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India