Criteria of the ISGPS for Grading Postpancreatectomy Hemorrhage (PPH)

An International Study Group of Pancreatic Surgery (ISGPS) reported a grading scheme for post-pancreatectomy hemorrhage.

Parameters:

(1) severity of hemorrhage (intra- and/or extra-luminal)

(2) timing: early (<= 24 hours after surgery) or late (> 24 hours after surgery)

(3) clinical status

(4) diagnosis

(5) management

Severity of Hemorrhage	Timing	Status	Diagnosis	Manage	Grade
mild	early	good	observation	none	A
severe	early	variable	additional testing	IV fluid, transfusion, possible intervention	B
mild	late	variable	additional testing	IV fluid, transfusion, possible intervention	B
severe	late	may be life threatening	aggressive	aggressive resuscitate, intervention	C

where:

• Intervention may include angiography with embolization or relaparoscopy.

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