Early postoperative fluid retention is a strong predictor for complications after pancreatoduodenectomy

HPB (Oxford). 2019 Dec;21(12):1784-1789. doi: 10.1016/j.hpb.2019.05.003. Epub 2019 Jun 1.

Abstract

Background: Perioperative fluid overload has been reported to increase complications after a variety of operative procedures. This study was conducted to investigate the incidence of fluid retention after pancreatic resection and its association with postoperative complications.

Methods: Data from 1174 patients undergoing pancreatoduodenectomy between 2010 and 2016 were collected from the Swedish National Pancreatic and Periampullary Cancer Registry. Early postoperative fluid retention was defined as a weight gain ≥2 kg on postoperative day 1. Outcome measures were overall complications, as well as procedure-specific complications.

Results: The weight change on postoperative day 1 ranged from -1 kg to +9 kg. A total of 782 patients (66.6%) were considered to have early fluid retention. Patients with fluid retention had significantly higher rates of total complications (p = 0.002), surgical complications (p = 0.001), pancreatic anastomotic leakage (p = 0.018) and wound infection (p = 0.023). Multivariable logistic regression confirmed early fluid retention as an independent risk factor for total complications (OR 1.46; p = 0.003), surgical complications (OR 1.49; p = 0.002), pancreatic anastomotic leakage (OR 1.48; p = 0.027) and wound infection (OR 1.84; p = 0.023).

Conclusions: Fluid retention is common after elective pancreatic resection, and its associated with an increased rate of postoperative complications.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Abscess / epidemiology
  • Aged
  • Anastomotic Leak / epidemiology
  • Body Fluids*
  • Cohort Studies
  • Female
  • Gastric Emptying
  • Humans
  • Male
  • Middle Aged
  • Pancreaticoduodenectomy*
  • Postoperative Complications / epidemiology*
  • Registries
  • Risk Factors
  • Surgical Wound Infection / epidemiology
  • Sweden / epidemiology
  • Weight Gain*