Perioperative fluids and complications after pancreatoduodenectomy within an enhanced recovery pathway
- Resource Type
- Authors
- Didier Roulin; Jérôme Gilgien; Nermin Halkic; Nicolas Demartines; Martin Hübner
- Source
- Scientific reports, vol. 10, no. 1, pp. 17898
Scientific Reports, Vol 10, Iss 1, Pp 1-9 (2020)
Scientific Reports
- Subject
- Male
Fluid administration
lcsh:Medicine
030230 surgery
Independent predictor
Article
Perioperative Care
Pancreaticoduodenectomy
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Clinical Protocols
Enhanced recovery
Humans
Medicine
Pancreatic disease
Infusions, Intravenous
lcsh:Science
Aged
Retrospective Studies
Multidisciplinary
business.industry
lcsh:R
Retrospective cohort study
Pancreatic cancer
Odds ratio
Perioperative
Middle Aged
Predictive value
Surgical oncology
030220 oncology & carcinogenesis
Anesthesia
Fluid Therapy
Female
lcsh:Q
Enhanced Recovery After Surgery
business
Complication
- Language
- English
Optimized fluid management is a key component of enhanced recovery (ERAS) pathways. Implementation is challenging for pancreatoduodenectomy (PD) and clear guidance is missing in the respective protocol. The aim of this retrospective study was to evaluate the influence of perioperative intravenous (IV) fluid administration on postoperative complications. 164 consecutive patients undergoing PD within ERAS between October 2012 and June 2017 were included. Perioperative IV fluid and morbidity (Clavien classification and comprehensive complication index (CCI)) were assessed. A threshold of more than 4400 ml IV fluid during the first 24 h could be identified to predict occurrence of complications (area under ROC curve 0.71), with a positive and negative predictive value of 93 and 23% respectively. More than 4400 ml intravenous fluids during the first 24 h was an independent predictor of overall postoperative complications (adjusted odds ratio 4.40, 95% CI 1.47–13.19; p value = 0.008). Patients receiving ≥ 4400 ml were associated with increased overall complications (94 vs 77%; p value