Endoscopic argon plasma coagulation as a method of haemostasis in bleeding from pancreatogastroanastomosis after pancreaticoduodenectomy

Objective. To evaluate the results of endoscopic argon plasma coagulation to stop bleeding from the pancreatogastroanastomosis after pancreaticoduodenectomy. Materials and methods. During the period 2019–2023, 48 pancreaticoduodenectomies were performed. At the stage of reconstruction, pancreatogastrostomy was used for the first time as an alternative to pancreatic jejunostomy. This type of reconstruction has a number of technical and anatomical advantages. Results. The incidence of postoperative bleeding was 12.5% (n=6). In all observations, intraluminal bleeding from the pancreatic stump into the gastric lumen was noted, which was not associated with the development of a pancreatic fistula. The use of argon plasma coagulation provided a one–stage bleeding control without the need for relaparotomy. Conclusions. Our clinical experience has shown encouraging immediate results. Argon plasma coagulation can be successfully used for bleeding from the pancreatic stump into the gastric lumen without the risk of anastomotic failure.