ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2023
Optimal Perioperative Fluid Therapy Associates with Fewer Complications After Pancreaticoduodenectomy.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 13 citations in OpenAlex.
- Comparison of Intraoperative Fluid by Goal-Directed and Conventional Fluid Administration in Patients Undergoing Early Decompressive Craniectomy: A Prospective Randomized Controlled Trial.Asian journal of neurosurgery · 2026Article
- Review
- 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
- PractIce pattern of INtraoperative FlUid therapy in elective major gastrointeStinal cancer surgEries in India (I-INFUSE): A multicentre observational study.Indian journal of anaesthesia · 2026Article
- Intraoperative fluid management is not predictive of AKI in major pancreatic surgery: a retrospective cohort study.Journal of anesthesia, analgesia and critical care · 2024Article
- The effect of an intraoperative patient-specific, surgery-specific haemodynamic algorithm in improving textbook outcomes for hepatobiliary-pancreatic surgery: a multicentre retrospective study.Frontiers in surgery · 2024Article
- Risk Factors of Postoperative Acute Pancreatitis and Its Impact on the Postoperative Course after Pancreaticoduodenectomy-10 Years of Single-Center Experience.Life (Basel, Switzerland) · 2023Article
- Comparisons of Electrolyte Balance Efficacy of Two Gelatin-Balanced Crystalloid for Surgery Patients Under General Anesthesia: A Multi-Center, Prospective, Randomized, Single-Blind, Controlled Study.International journal of general medicine · 2023Article
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4 authors at 1 institution in 1 country.
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Abstract
backgroundOptimal fluid management in pancreaticoduodenectomy patients remains contested. We aimed to examine the association between perioperative fluid administration and postoperative complications.
methodsWe studied 168 pancreaticoduodenectomy patients operated in 2015 (n = 93) or 2017 (n = 75) at Helsinki University Hospital. In 2015, patients received intraoperative fluids following a goal-directed approach and, in 2017, according to anesthesiologist's clinical practice (conventional fluid management). We analyzed the differences in perioperative fluid administration between the groups, specifically examining the occurrence of severe complications (Clavien-Dindo ≥ III), pancreatic fistulas, cardiovascular complications, and the length of hospital stay.
resultsThe goal-directed group received more intraoperative fluids than the conventional fluid management group (12.0 ml/kg/h vs. 8.3 ml/kg/h, p < 0.001). Urine output (770 ml vs. 575 ml, p = 0.004) and intraoperative fluid balance (9.4 ml/kg/h vs. 6.3 ml/kg/h, p < 0.001) were higher in the goal-directed group than in the conventional fluid management group. Severe surgical complications (19.4% vs. 38.7%, p = 0.009) as well as clinically relevant pancreatic fistulas (1.1% vs. 10.7%, p = 0.011) occurred more frequently in patients receiving conventional fluid management. Moreover, the conventional fluid management group experienced longer hospital stays (9.0 vs. 11.5 days, p = 0.02). Lower intraoperative fluid volume accompanying conventional fluid management was associated with a higher risk of severe postoperative complications compared with higher volume in the goal-directed group (odds ratio 2.58 (95% confidence interval 1.04-6.42), p = 0.041).
conclusionsThe goal-directed group experienced severe complications less frequently. Our findings indicate that optimizing the intraoperative fluid administration benefits patients, while adopting a too-restrictive approach represents an inferior choice.
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