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- W2890955731 abstract "Background: Postoperative pancreatic fistula (POPF) remains a common and dreaded complication after pancreaticoduodenectomy (PD). Previous literature on intestinal anastomosis suggests that liberal perioperative fluid administration may contribute to poor anastomotic healing. We aim to evaluate the relationship between perioperative fluid resuscitation and development of POPF after PD. Methods: In this single-institution retrospective study, we analyzed net fluid resuscitation over the first 72 hours of patients who underwent PD between 2013 and 2017. One hundred and four patients were categorized by tertile into low, medium, and high fluid volume groups. POPF was defined by the International Study Group of Pancreas Surgeons’ 2016 update, and only Grade B and C POPF were included. Statistics were performed using Chi-square, ANOVA and multivariate analyses. Results: POPF was identified in 17.3% of patients (n = 18). No significant differences in race, sex, ASA, smoking status, hemoglobin A1C, and prevalence of chronic pancreatitis were identified between low, medium and high volume groups. Similarly, there were no differences in operative time, blood loss, intraoperative fluid administration, use of internal pancreatic stents, or postoperative lactate (all p > 0.05). Patients with high 72-hour net fluid balance had a significantly higher rate of POPF compared to medium and low volume groups (31.4% vs. 11.4% vs. 8.8%, p = 0.024). On multivariate analysis, increasing net fluid balance was significantly associated with POPF (OR 1.25, CI 1.02-1.54, p = 0.03). Conclusion: In patients undergoing PD, high net 72-hour fluid balance is significantly associated with development of POPF. Given increasing efforts to develop enhanced recovery pathways that minimize PD morbidity, net fluid balance may represent both a clinical predictor and modifiable target for prevention of POPF." @default.
- W2890955731 created "2018-09-27" @default.
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- W2890955731 date "2018-03-01" @default.
- W2890955731 modified "2023-09-26" @default.
- W2890955731 title "Does perioperative fluid resuscitation impact pancreatic fistula rates after pancreaticoduodenectomy?" @default.
- W2890955731 doi "https://doi.org/10.1016/j.hpb.2018.02.064" @default.
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