Highlights
- •Restrictive intra-operative fluids did not increase post-operative AKI rates.
- •Restrictive fluids associated with reduced Clavien-Dindo I-II complications.
- •Longer length of surgery associated with post-operative acute kidney injury.
Abstract
Background
The amount of IV fluids sufficient to prevent post-operative acute kidney injury (AKI)
during pancreaticoduodenectomy (PD) is unknown. We assessed the restrictive IOIVF
use in PD on the rate of post-operative AKI, delayed gastric emptying and ileus, and
pancreatic fistulas (POPF).
Methods
Patients who underwent PD between 2012 and 2017 were reviewed. Univariate and multivariate
analyses looked for association between pre- and intra-operative factors on AKI, ileus
and POPF.
Results
Of 395 included patients, 97, 172, and 126 patients received less than 1000 mL (ultra-restrictive),
1000 mL to less than 2000 mL (restrictive), and 2000 mL and greater (nonrestrictive)
normalized total IOIVF respectively. Of these 23 (24.2%), 34(20.4%), and 21(17.4%)
developed AKI respectively, most of them mild. There was no difference in odds of
developing AKI, ileus, or pancreatic fistula among fluid groups. While there was no
difference in Clavien-Dindo III-IV complications, the incidence of Clavien-Dindo type
I-II complications was lower in the restricted fluid groups.
Discussion
Restricted fluids did not lead to higher AKI rates but were associated with fewer
low-grade complications.
Keywords
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Article info
Publication history
Published online: March 23, 2020
Accepted:
March 19,
2020
Received in revised form:
March 8,
2020
Received:
November 25,
2019
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
