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Effect of intra-operative fluid volume on peri-operative outcomes after pancreaticoduodenectomy for pancreatic adenocarcinoma

Authors

  • Marcovalerio Melis MD,

    Corresponding author
    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
    • Assistant Professor of Surgery, New York University School of Medicine, 423 East 23rd Street, Room 4153 N, New York, NY 10010. Fax: +1-212-951-3373.===

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  • Francesca Marcon MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • Antonio Masi MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • Umut Sarpel MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • George Miller MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • Harvey Moore MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • Steven Cohen MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
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  • Russell Berman MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • H Leon Pachter MD,

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • Elliot Newman MD

    1. Department of Surgery, New York University School of Medicine, New York, New York
    2. Division of Surgical Oncology, New York University School of Medicine, New York, New York
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  • Synopsis for Table of Contents: Controversy continues to revolve around appropriate fluid resuscitation during elective major surgery. This manuscript investigates whether volume of intra-operative crystalloids affects outcomes following pancreaticoduodenectomy for pancreatic adenocarcinoma.

Abstract

Background

Excess use of intravenous fluid can increase post-operative complications. We examined the influence of intra-operative crystalloid (IOC) administration on complications following pancreaticodudenectomy (PD) for pancreatic adenocarcinoma.

Methods

We categorized 188 patients who underwent PD for adenocarcinoma (1990–2009) into two groups: Group I received <6,000 ml and Group II received ≥6,000 ml IOC. Differences between groups in length of stay, overall morbidity, and 30-day mortality were evaluated.

Results

There were 86 patients in Group I and 102 in Group II. Group I patients were older and with higher percentage of women, but similar in regards to performance status, ASA score, underlying comorbidities, and administration of neo-adjuvant treatment. Group II patients had longer operations, increased blood loss, and higher rates of intra-operative blood transfusions. There were two post-operative deaths, both in the Group II (P = 0.5). Post-operative overall morbidity was 45.7%, without differences between the two groups (44.2% vs. 47.1%, P = 0.7). Likewise, length of post-operative stay was similar in both groups (13.8 days vs. 14.5 days, P = 0.5).

Conclusions

The volume of IOC increased with duration of surgery, intra-operative blood losses, and intra-operative blood transfusion, but did not correlate with post-operative morbidity. J. Surg. Oncol. 2012; 105:81–84. © 2011 Wiley Periodicals, Inc.

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