Postoperative Complications
Conditions
Keywords
pancreaticoduodenectomy, Clavien-Dindo classification, pancreatic fistulas
Brief summary
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.
Detailed description
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.
Interventions
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.
Sponsors
Helsinki University Central Hospital
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* age 18 or over * patients who underwent pancreaticoduodenectomy in 2015 or in 2017
Exclusion criteria
* patients whose patient record information is insufficient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intraoperative fluid volume | The duration of the surgery | The amount of fluid (crystalloids and albumin) patients got during the surgery |
| Postoperative complications (Clavien-Dindo classification) | Postoperative day 0-30 | The rate of severe Clavien-Dindo complications (3-5) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Pancreatic fistulas | Postoperative day 0-30 | The rate of severe pancreatic fistulas (grade B-C) |
| Intraoperative fluid balance | The duration of the surgery | The change in intraoperative fluid intake (crystalloids, colloids, blood products) and fluid output (urine output, blood loss, evaporation) in millilitres and ml/kg. |
| Severe surgical complications | Postoperative day 0-30 | The rate of surgical complications (Clavien Dindo 3-5), without cardiopulmonary complications |
| Postoperative fluid balance | Postoperative day 1-3 | The change in postoperative fluid intake (crystalloids, colloids, blood products) and fluid output (urine output, secretion in drains etc.) in millilitres. |
| Postoperative fluid volume | Postoperative day 0-3 | The amount of fluid patients got postoperatively |
| Cardiopulmonary complications | Postoperative day 0-30 | The rate of cardiopulmonary complications e.g., congestive heart failure, pleural effusion, dyspnea. |
Outcome results
None listed