title: Correlation between peri-operative serum lactate levels and outcome in pancreatic resection for pancreatic cancer, preliminary report.
abstract: This study was undertaken in order to verify if peri-operative serum lactate level changes, resulting from manipulation of the splanchnic circulation during pancreatectomy, reflected clinical outcome in twenty patients (9 males-11 females age 33 to 76) operated for pancreatic cancer. Lactate levels were evaluated at the beginning of the procedure (T0), after surgical manipulation before pancreatic resection (T1), after resection (T2), and 24 hours post-op. (T3). Furthermore, to highlight possible hemodynamic instability that could contribute to altered lactate clearance, mean arterial pressure (MAP) and central venous pressure (CVP) were continuously monitored during the study period. Peri-operative mortality within 60 days after surgery, Intensive Care Unit (ICU) length of stay, and peri-operative complications were the main indicators investigated in order to evaluate the impact of serial lactate levels in this patient population. Hyperlactatemia observed peri-operatively during pancreatic resection for cancer is significantly correlated with peri-operative mortality and also with longer ICU length of stay. Though, due to the relatively small number of the patients, more extensive investigation is needed in order to confirm such interesting preliminary data.
authors.affiliation: Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Pittsburgh, PA, USA. sgruttadauria@ismett.edu
authors.forename: S
authors.initials: S
authors.lastname: Gruttadauria
authors.forename: I R
authors.initials: IR
authors.lastname: Marino
authors.forename: C H
authors.initials: CH
authors.lastname: Vitale
authors.forename: L
authors.initials: L
authors.lastname: Mandala
authors.forename: V L
authors.initials: VL
authors.lastname: Scott
authors.forename: C
authors.initials: C
authors.lastname: Doria
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000097:blood / Q000401:mortality / Q000601:surgery*; D012044:Regression Analysis; D012189:Retrospective Studies; D013152:Splanchnic Circulation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007773:Lactates