Cargando…
Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy
PURPOSE: Despite the many efforts to overcome postoperative complications, pancreaticoduodenectomy (PD) is still accompanied with considerable concerns of lethal complications. The clinical factors are known to affect postoperative outcomes such as diameter of pancreatic duct, texture of pancreas, a...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Surgical Society
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914521/ https://www.ncbi.nlm.nih.gov/pubmed/35317358 http://dx.doi.org/10.4174/astr.2022.102.3.139 |
_version_ | 1784667728378855424 |
---|---|
author | Jeon, Hyun-Jeong Kwon, Hyung-Jun Hwang, Yoon-Jin Kim, Sang-Geol |
author_facet | Jeon, Hyun-Jeong Kwon, Hyung-Jun Hwang, Yoon-Jin Kim, Sang-Geol |
author_sort | Jeon, Hyun-Jeong |
collection | PubMed |
description | PURPOSE: Despite the many efforts to overcome postoperative complications, pancreaticoduodenectomy (PD) is still accompanied with considerable concerns of lethal complications. The clinical factors are known to affect postoperative outcomes such as diameter of pancreatic duct, texture of pancreas, and comorbidity of the patients are mostly uncorrectable. Thus, investigation for correctable risk factors is required. Recently, perioperative fluid volume was reported to be associated with complications after PD. This study aims to determine the relationship between postoperative fluid balance and surgical outcome after open PD. METHODS: We reviewed, retrospectively, 172 consecutive patients who underwent open PD in a single institution between 2015 and 2019. The status of perioperative fluid balance 2 days after surgery and clinical factors were investigated to determine the association with postoperative outcome including postoperative pancreatic fistula (POPF). According to postoperative fluid balance, patients were divided into high- and low-balance groups, and clinical features and surgical outcomes were compared between both groups. Multivariate analysis were performed to identify risk factors for POPF. RESULTS: The percentage of morbidity and the incidence of POPF were higher in the high-balance group compared to the low-balance group (61.6% vs. 37.2%, P = 0.001; 15.1% vs. 3.5%, P = 0.009). High postoperative fluid balance and the presence cardiovascular disease were correlated with POPF on multivariate analysis (odds ratio [OR], 4.574; 95% confidence interval [CI], 1.229–17.029; P = 0.023 and OR, 3.517; 95% CI, 1.209–12.017; P = 0.045). CONCLUSION: Higher amount of postoperative fluid balance and the presence of cardiovascular disease are associated with POPF after PD. |
format | Online Article Text |
id | pubmed-8914521 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | The Korean Surgical Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-89145212022-03-21 Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy Jeon, Hyun-Jeong Kwon, Hyung-Jun Hwang, Yoon-Jin Kim, Sang-Geol Ann Surg Treat Res Original Article PURPOSE: Despite the many efforts to overcome postoperative complications, pancreaticoduodenectomy (PD) is still accompanied with considerable concerns of lethal complications. The clinical factors are known to affect postoperative outcomes such as diameter of pancreatic duct, texture of pancreas, and comorbidity of the patients are mostly uncorrectable. Thus, investigation for correctable risk factors is required. Recently, perioperative fluid volume was reported to be associated with complications after PD. This study aims to determine the relationship between postoperative fluid balance and surgical outcome after open PD. METHODS: We reviewed, retrospectively, 172 consecutive patients who underwent open PD in a single institution between 2015 and 2019. The status of perioperative fluid balance 2 days after surgery and clinical factors were investigated to determine the association with postoperative outcome including postoperative pancreatic fistula (POPF). According to postoperative fluid balance, patients were divided into high- and low-balance groups, and clinical features and surgical outcomes were compared between both groups. Multivariate analysis were performed to identify risk factors for POPF. RESULTS: The percentage of morbidity and the incidence of POPF were higher in the high-balance group compared to the low-balance group (61.6% vs. 37.2%, P = 0.001; 15.1% vs. 3.5%, P = 0.009). High postoperative fluid balance and the presence cardiovascular disease were correlated with POPF on multivariate analysis (odds ratio [OR], 4.574; 95% confidence interval [CI], 1.229–17.029; P = 0.023 and OR, 3.517; 95% CI, 1.209–12.017; P = 0.045). CONCLUSION: Higher amount of postoperative fluid balance and the presence of cardiovascular disease are associated with POPF after PD. The Korean Surgical Society 2022-03 2022-03-04 /pmc/articles/PMC8914521/ /pubmed/35317358 http://dx.doi.org/10.4174/astr.2022.102.3.139 Text en Copyright © 2022, the Korean Surgical Society https://creativecommons.org/licenses/by-nc/4.0/Annals of Surgical Treatment and Research is an Open Access Journal. All articles are distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Jeon, Hyun-Jeong Kwon, Hyung-Jun Hwang, Yoon-Jin Kim, Sang-Geol Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
title | Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
title_full | Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
title_fullStr | Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
title_full_unstemmed | Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
title_short | Unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
title_sort | unfavorable effect of high postoperative fluid balance on outcome of pancreaticoduodenectomy |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8914521/ https://www.ncbi.nlm.nih.gov/pubmed/35317358 http://dx.doi.org/10.4174/astr.2022.102.3.139 |
work_keys_str_mv | AT jeonhyunjeong unfavorableeffectofhighpostoperativefluidbalanceonoutcomeofpancreaticoduodenectomy AT kwonhyungjun unfavorableeffectofhighpostoperativefluidbalanceonoutcomeofpancreaticoduodenectomy AT hwangyoonjin unfavorableeffectofhighpostoperativefluidbalanceonoutcomeofpancreaticoduodenectomy AT kimsanggeol unfavorableeffectofhighpostoperativefluidbalanceonoutcomeofpancreaticoduodenectomy |