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

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.

Keywords: :

• pancreaticoduodenectomy
• perioperative fluid therapy
• pancreatic fistulas
• postoperative morbidity
• periampullary cancer
• risk factors