The effect of intraoperative fluid volume administration on pancreatic fistulas after pancreaticoduodenectomy

J Invest Surg. 2014 Apr;27(2):88-94. doi: 10.3109/08941939.2013.839766.

Abstract

Background: Fluid therapy may be one of the most controversial topics in perioperative management. However, data concerning the influence of perioperative fluid administration on complications after pancreaticoduodenectomy are sparse.

Methods: A group of 147 patients underwent pancreaticoduodenectomy for benign or malignant pathology of the pancreas or the periampullary region between 2005 and 2009. Clinical data, overall morbidity, and long-term outcomes were recorded.

Results: We categorized the patients into two groups according to intraoperative fluid volume administration: a low fluid volume group (LFVG, <8.2 ml kg(-1) hr(-1), n = 90) group, and a high fluid volume group (HFVG, ≥8.2 ml kg(-1) hr(-1), n = 57). In terms of colloid administration, the high fluid volume group received significantly more colloid both during the intraoperative period and 0-12 hr after surgery (p < .001 and p < .007, respectively). Pancreatic fistula rates were significantly greater in the high fluid volume group (p = .035). However, the long-term survival rate was not different between the two groups.

Conclusions: High intraoperative fluid volume administration is associated with an increased incidence of pancreatic fistulas after pancreaticoduodenectomy.

MeSH terms

  • Adenocarcinoma / mortality
  • Adult
  • Aged
  • Colloids / administration & dosage
  • Female
  • Fluid Therapy / methods*
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Pancreatic Fistula / etiology*
  • Pancreaticoduodenectomy / adverse effects*
  • Perioperative Care / methods*
  • Postoperative Complications / epidemiology
  • Retrospective Studies

Substances

  • Colloids