ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2018
Clinical Implications of Intraoperative Fluid Therapy in Pancreatic Surgery.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Clinical relevance of intraoperative blood loss in pancreatic surgery: a systematic review and meta-analysis to reappraise the impact on post operative pancreatic fistula.Langenbeck's archives of surgery · 2025Pooled it
- Comparison of the change in carotid corrected flow time and stroke volume variation for assessing volume responsiveness in general anesthesia patients: a prospective, observational study.Journal of clinical monitoring and computing · 2026Observational
- Association of perioperative patient characteristics, intraoperative fluid management, and vasopressors with anastomotic leakage after Ivor-Lewis esophagectomy-a single center retrospective cohort.Surgical endoscopy · 2026Article
- Intraoperative hemodynamic management during pancreatoduodenectomy - an analysis of 525 patients.Langenbeck's archives of surgery · 2025Article
- Intraoperative fluid management is not predictive of AKI in major pancreatic surgery: a retrospective cohort study.Journal of anesthesia, analgesia and critical care · 2024Article
- Optimal Perioperative Fluid Therapy Associates with Fewer Complications After Pancreaticoduodenectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- The clinical impact of the perioperative epidural anesthesia on surgical outcomes after pancreaticoduodenectomy: A retrospective cohort study.Surgery open science · 2022Article
- A Single-Center Retrospective Study of Selected Clinical Parameters and Intraoperative Fluid Management of Patients Undergoing Pancreatoduodenectomy.Medical science monitor : international medical journal of experimental and clinical research · 2022Article
- Hyperspectral imaging for perioperative monitoring of microcirculatory tissue oxygenation and tissue water content in pancreatic surgery - an observational clinical pilot study.Perioperative medicine (London, England) · 2021Article
- Pancreatoduodenectomy associated with colonic resections: indications, pitfalls, and outcomes.Updates in surgery · 2021Review
- [Perioperative fluid management in major abdominal surgery].Der Anaesthesist · 2021Review
- Correlation between Intraoperative Fluid Administration and Outcomes of Pancreatoduodenectomy.Gastroenterology research and practice · 2020Article
- The clinical impact of the systolic volume variation guided intraoperative fluid administration regimen on surgical outcomes after pancreaticoduodenectomy: a retrospective cohort study.Brazilian journal of anesthesiology (Elsevier)Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent studies have suggested that intraoperative fluid overload is associated with a worse outcome after major abdominal surgery. However, evidence in the field of pancreatic surgery is still not consistent. The aim of this study was to evaluate whether intraoperative fluid management could affect the outcome of a major pancreatic resection.
methodsProspective analysis of 350 major pancreatic resections performed in 2016 at the Department of General and Pancreatic Surgery-The Pancreas Institute, University of Verona Hospital Trust. Patients were dichotomized according to intraoperative fluid volume administration (near-zero vs. liberal fluid balance) and matched using propensity score. Intraoperative fluid administration was then correlated to the postoperative outcome.
resultsLiberal fluid balance was associated with an increased rate of Clavien-Dindo ≥ IIIB both after pancreaticoduodenectomy (60.3 vs. 30.2%, p < 0.01) and distal pancreatectomy (50 vs. 27.1%, p = 0.03). In case of pancreaticoduodenectomy, liberal fluid balance was also associated with an increased rate of pancreatic fistula (33.3 vs. 19.9%, p = 0.05), but when considering patients with soft remnants, an increase rate of pancreatic fistula (52.8 vs. 23%, p = 0.03) was indeed associated with the near-zero fluid balance.
conclusionConsidering all pancreatic resections, a liberal fluid balance is associated with an increased rate of postoperative morbidity. However, in the case of PD with a soft pancreas, an NZF balance could lead to pancreatic stump ischemia and anastomotic failure. Intraoperative fluid management should be managed according to patient's pancreas-specific risk factors.
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