目的：评估数字减影血管造影（DSA）在胰十二指肠切除术（PD）后迟发性出血中的临床疗效及应用价值。方法：对2019年1月至2024年12月期间在复旦大学附属中山医院接受DSA治疗的38例PD术后迟发性出血病人的临床资料进行回顾性分析，重点评估介入治疗的技术成功率及临床效果。结果：在726例PD手术病人中，38例（5.2%）发生迟发性出血。其中，30例（78.9%）DSA检查显示阳性结果。出血部位分布如下：胃十二指肠动脉18例，肝总动脉1例，空肠动脉第一支2例，肝固有动脉2例，肝右动脉1例，肝中动脉1例，肝左动脉3例，脾动脉起始部1例，胃网膜右动脉1例。介入治疗方式包括微弹簧圈栓塞（17例）、微弹簧圈联合明胶海绵栓塞（4例）、覆膜支架植入（7例）及单纯明胶海绵和微球栓塞（各1例）。28例（93.3%）通过DSA介入治疗成功止血，2例因再发出血需行手术止血。结论：DSA引导下介入栓塞治疗具有创伤小、定位精准、止血效果确切等优势，可作为PD术后迟发性出血的首选治疗策略。

Objective To evaluate the clinical efficacy and application value of digital subtraction angiography (DSA) in the management of delayed pancreaticoduodenectomy(PD) hemorrhage(PPH).Methods A retrospective analysis was conducted on the clinical data of 38 patients who underwent DSA for delayed PPH at Zhongshan Hospital, Fudan University, between January 2019 and December 2024. The technical success rate and clinical outcomes of interventional treatment were the primary focus of the evaluation.Results Among 726 patients who underwent PD, 38 (5.2%) experienced delayed bleeding. Of these, 30 (78.9%) showed positive findings on DSA. The distribution of bleeding sites was as follows: gastroduodenal artery (18 cases), common hepatic artery (1 case), the first branch of the jejunal artery (2 cases), proper hepatic artery (2 cases), right hepatic artery (1 case), middle hepatic artery (1 case), left hepatic artery (3 cases), origin of the splenic artery (1 case), and right gastroepiploic artery (1 case). Interventional treatments included microcoil embolization (17 cases), microcoil combined with gelatin sponge embolization (4 cases), covered stent implantation (7 cases), and gelatin sponge embolization alone and microspheres embolization (1 case each). Successful hemostasis was achieved in 28 (93.3%) patients through DSA-guided interventional treatment, while 2 patients required surgical hemostasis due to recurrent bleeding.Conclusions DSA-guided interventional embolization offers advantages such as minimal invasiveness, precise localization, and effective hemostasis, making it the preferred treatment strategy for delayed PPH.