Effect of intra‐operative fluid volume on peri‐operative outcomes after pancreaticoduodenectomy for pancreatic adenocarcinoma

Abstract

The volume of IOC increased with duration of surgery, intra-operative blood losses, and intra-operative blood transfusion, but did not correlate with post-operative morbidity.

The Effect of Intraoperative Fluid Volume Administration on Pancreatic Fistulas after Pancreaticoduodenectomy

“…One patient in the low fluid volume group died of a hemorrhage on postoperative (17) 14 (16) 11 (19) .556 Diabetes mellitus, n (%) 6 (4) 3 (3) 3 (5) .565 Hypertension, n (%) 9 (6) 6 (7) 3 (5 Â The colloid volume 0-12 hr after surgery was significantly higher in the high fluid volume group. "Crystalloids" represent the mixture of 0.9% saline, 5% glucose, and lactated Ringer's solution.…”

“…This regimen, however, is not evidence-based. Because the appropriate amount of fluid to be administered during pancreaticoduodenectomy has never been defined in the literature [5], we arbitrarily categorized the patients into two groups: a low fluid volume group (LFVG, <8.2 ml kg −1 hr −1 , n = 90), and a high fluid volume group (HFVG, ≥8.2 ml kg −1 hr −1 , n = 57).…”

“…Fluid therapy may be one of the most controversial topics in perioperative management [1][2][3][4][5]. Hypovolemia is well recognized as a risk factor for adverse effects, ranging from minor organ dysfunction to multi-organ failure and even death.…”

“…Limited surgical experience, greater age, extended resection, higher preoperative serum bilirubin level, and soft pancreatic texture have been reported to be the most prominent independent risk factors for mortality and postoperative complications following pancreaticoduodenectomy in high-volume institutions. However, clinical experience with perioperative fluid administration during pancreaticoduodenectomy has been limited [5]. The objective of our study was to determine the perioperative and long-term outcomes after pancreaticoduodenectomy as well as the relationships of these outcomes with intraoperative and postoperative fluid administration.…”

Impact of fluid resuscitation on major adverse events following pancreaticoduodenectomy

“…5 However, several recent studies have examined the impact of fluid resuscitation on the development of postoperative complications and have correlated liberal fluid administration with bowel edema and anastomotic compromise. [6][7][8][9][10][11][12][13][14] Specifically, excessive postoperative fluid resuscitation has been found to cause bowel edema at the site of the anastomosis and has been implicated to cause anastomotic leak in colorectal surgery.…”