Complications after duodenopancreatectomy within eras protocols in a developing country nbsp

Background Recent studies have suggested that intraoperative fluid overload is associated with the presence of postoperative pancreatic fistula after duodenopancreatectomy Finding the ideal balance between hypoperfusion and tissue edema with fluids administration during major gastrointestinal surgery is challenging The aim of this study was to evaluate whether intraoperative fluid management along with enhanced recovery protocols could affect the outcome after a major pancreatic resection Methods Data from consecutive patients who underwent duodenopancreatectomy from January to January were analyzed Patients were divided into two groups according to the use of enhanced recovery after surgery protocols Patients in ERAS protocols had a fluid therapy algorithm which consists Systolic Volume Variation SVV less than Cardiac Index CI higher than L Min M and Delta CO less than mmHg Results A total of patients were analyzed from July to January of these correspond to the female gender The most frequent diagnosis was Pancreatic Cancer n followed by Intraductal Papillary Mucinous Neoplasm IPMN n The majority of patients were in the ERAS Group with a total of patients In the ERAS group and did not develop POPF and Delayed Gastric Emptying DGE respectively The incidence of POFP in all the patients was Grade A are considered biochemical leak and NOT a proper fistula The incidence of DGE was The probability of intraoperative blood loss less than ml was higher in the ERAS group however the probability to need a transfusion was lower in the ERAS Group The probability to use less than ml of fluid therapy was higher in the ERAS group The total length of stay was statistically significant shorter in the ERAS group No differences in days mortality were found Conclusion The implementation of ERAS protocols in PD did show a decrease in intraoperative blood loss intravenous fluids therapy need for transfusion DGE and total hospital stay however intraoperative fluid restriction in PD did not show to significantly affect POPF