Postoperative complication rates in patients undergoing pancreaticoduodenectomy remain high although the operation techniques have developed a lot in recent years. There is evidence that restrictive intraoperative fluid therapy could decrease postoperative complication rates but the results of the former studies have been somewhat controversial. The aim of this study is to examine whether the intraoperative and postoperative fluid therapy affect to the postoperative complication rates in patients undergoing pancreaticoduodenectomy.
The study is a retrospective cohort study. The first cohort consists of patients who underwent pancreaticoduodenectomy in year 2015 when intraoperative fluid therapy were managed using goal directed fluid therapy technique. The second cohort consists of patients who underwent pancreaticoduodenectomy in year 2017 when intraoperative fluid therapy were based on the consideration of the anaesthesiologist. In 2015 most of the patients spent the first postoperative night in the ICU where the fluid management and monitoring of the urine output and vital functions were more controlled than in the normal ward. In 2017 most of the patients got in the regular ward right after the surgery. The aim of the study is to examine whether there are differences in the amounts of the intraoperative and postoperative fluids between the cohorts and does the perioperative fluid therapy affect to the complication rates.
Study Type
OBSERVATIONAL
Enrollment
168
Patients in 2015 got intraoperative fluid therapy in goal directed fluid therapy technique.
Patients in 2017 got liberal intraoperative fluid therapy influenced by their anaesthesiologist.
Intraoperative fluid volume
The amount of fluid (crystalloids and albumin) patients got during the surgery
Time frame: The duration of the surgery
Postoperative complications (Clavien-Dindo classification)
The rate of severe Clavien-Dindo complications (3-5)
Time frame: Postoperative day 0-30
Severe surgical complications
The rate of surgical complications (Clavien Dindo 3-5), without cardiopulmonary complications
Time frame: Postoperative day 0-30
Cardiopulmonary complications
The rate of cardiopulmonary complications e.g., congestive heart failure, pleural effusion, dyspnea.
Time frame: Postoperative day 0-30
Pancreatic fistulas
The rate of severe pancreatic fistulas (grade B-C)
Time frame: Postoperative day 0-30
Postoperative fluid volume
The amount of fluid patients got postoperatively
Time frame: Postoperative day 0-3
Intraoperative fluid balance
The change in intraoperative fluid intake (crystalloids, colloids, blood products) and fluid output (urine output, blood loss, evaporation) in millilitres and ml/kg.
Time frame: The duration of the surgery
Postoperative fluid balance
The change in postoperative fluid intake (crystalloids, colloids, blood products) and fluid output (urine output, secretion in drains etc.) in millilitres.
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Time frame: Postoperative day 1-3