title: Effect of intra-operative fluid volume on peri-operative outcomes after 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.
authors.affiliation: Department of Surgery, New York University School of Medicine, New York, New York, USA. marcovalerio.melis@nyumc.org
authors.forename: Marcovalerio
authors.initials: M
authors.lastname: Melis
authors.forename: Francesca
authors.initials: F
authors.lastname: Marcon
authors.forename: Antonio
authors.initials: A
authors.lastname: Masi
authors.forename: Umut
authors.initials: U
authors.lastname: Sarpel
authors.forename: George
authors.initials: G
authors.lastname: Miller
authors.forename: Harvey
authors.initials: H
authors.lastname: Moore
authors.forename: Steven
authors.initials: S
authors.lastname: Cohen
authors.forename: Russell
authors.initials: R
authors.lastname: Berman
authors.forename: H Leon
authors.initials: HL
authors.lastname: Pachter
authors.forename: Elliot
authors.initials: E
authors.lastname: Newman
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies