Goal-directed Fluid Therapy on Complications After Pancreaticoduodenectomy
Słowa kluczowe
Abstrakcyjny
Opis
Retrospective study of 10564 patients undergoing pancreaticoduodenectomy at a single institution from January, 2015 through July, 2016. Stroke volume variation (SVV) was tracked and titrated during the procedure.
All patients were seen preoperatively in the department clinic setting, and indications for pancreaticoduodenectomy were for pancreatic adenocarcinoma, neuroendocrine tumors, chronic pancreatitis, non-adeno malignancy, and other benign. benign and malignant disease.
Patients were excluded if they had any of the following during surgery: venous resection and reconstructive involving the portal venous system; estimated blood loss exceeding two liters; high dose steroid administration; use of irreversible electroporation for margin enhancement; lack of SVV equipment or inconsistent SVV recordings; use of the robotic surgical system.
Primary outcomes measures were recorded for each patient were: pancreatic leak and delayed gastric emptying. Pancreatic leak was defined according to the international study group for pancreatic fistulas: "an external fistula with a drain output of any measurable volume after postoperative day three with an amylase level greater than three times the upper limit of the normal serum value." Delayed gastric emptying was defined clinically as persistent postoperative emesis requiring nasogastric tube placement, prokinetic agents, or hospital readmission for endoscopic gastrostomy placement.
A comparative analysis of postoperative complications was performed between patients with a median SVV < 12 during the extirpative and reconstructive phases of the procedure compared with patients with an SVV > 12. The investigators chose an SVV value of greater than 12 to represent a "dry" state because previous studies have shown that this value represents decreased fluid administration.
Daktyle
Ostatnia weryfikacja: | 09/30/2018 |
Pierwsze przesłane: | 10/02/2018 |
Szacowana liczba przesłanych rejestracji: | 10/04/2018 |
Wysłany pierwszy: | 10/08/2018 |
Ostatnia aktualizacja przesłana: | 10/04/2018 |
Ostatnia opublikowana aktualizacja: | 10/08/2018 |
Rzeczywista data rozpoczęcia badania: | 12/31/2014 |
Szacowana data zakończenia podstawowej działalności: | 07/30/2016 |
Szacowana data zakończenia badania: | 07/30/2016 |
Stan lub choroba
Faza
Grupy ramion
Ramię | Interwencja / leczenie |
---|---|
Patients with SVV < 12 Patients undergoing pancreaticoduodenectomy with an intraoperative stroke volume variation of less than 12. | |
Patients with SVV > or = 12 Patients undergoing pancreaticoduodenectomy with an intraoperative stroke volume variation of greater than or equal to 12. |
Kryteria kwalifikacji
Płeć kwalifikująca się do nauki | All |
Metoda próbkowania | Non-Probability Sample |
Przyjmuje zdrowych wolontariuszy | Nie |
Kryteria | Inclusion Criteria: • pancreatic adenocarcinoma, neuroendocrine tumors, chronic pancreatitis, non-adeno malignancy, and other benign lesion Exclusion Criteria: - venous resection and reconstructive involving the portal venous system - estimated blood loss exceeding two liters - high dose steroid administration - use of irreversible electroporation for margin enhancement - lack of SVV equipment or inconsistent SVV recordings - use of the robotic surgical system |
Wynik
Podstawowe miary wyników
1. Postoperative complications (Pancreatic leak and delayed gastric emptying) [30 days postoperatively]