Analysis of complications after Whipple's procedure using ERAS protocols

  • Juan Pablo Aristizabal-Linares CES Clinic, Medellín, Colombia
  • José Julián Estrada-Quiroz CES Clinic, Medellín, Colombia
  • Carolina Hoyos-Gómez CES University, Medellín, Colombia
  • Diego Fernando Dávila-Martínez CES Clinic, Medellín, Colombia
  • Oscar Germán Palacios-Rodríguez CES Clinic, Medellín, Colombia
  • Paola Sánchez-Zapata CES University, Medellín, Colombia
Keywords: Pancreaticoduodenectomy, Fluid Therapy, Fistula, Complications

Abstract

Background:

The administration of perioperative fluids is a controversial issue that can be associated with the development of postoperative pancreatic fistula (POPF) after Whipple procedure.

Objective:

To evaluate whether intraoperative fluid management along with Enhanced Recovery after Surgery (ERAS) protocols affect outcomes following major pancreatic resection.

Methods:

A retrospective cohort study was conducted from January 2012 to January 2017, collecting all patients scheduled for duodenopancreatectomy (DP). Patients were divided into 2 groups according to the use of ERAS protocols and the use of a fluid therapy algorithm.

Results:

A total of 67 patients were analyzed, 49.3% of which were females. The most frequent diagnoses were Pancreatic Cancer n:48 (71.6%), followed by intraductal papillary mucinous neoplasm n:6 (9%). The majority of patients were in the ERAS group n:46 (68.7%); 80.4% and 95.7% of them did not develop pancreatic fistula or delayed gastric emptying (DGE) respectively, and the incidence for both was 11.94%. Fluid therapy was below 5000 mL (P=0.001) with blood loss less 300 mL (P = 0.001) in the ERAS group. The length of stay was shorter in the ERAS group (7 days, interquartilel range 5-12, P < 0.001). No differences in 30 days mortality were found.

Conclusion:

The implementation of ERAS protocols in DP did show a decrease in intraoperative blood loss, intravenous fluids therapy, need for transfusion, DGE, or total hospital stay. However, intraoperative fluid restriction in DP did not show a reduction in the development of POPF.

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How to Cite
1.
Aristizabal-Linares JP, Estrada-Quiroz JJ, Hoyos-Gómez C, Dávila-Martínez DF, Palacios-Rodríguez OG, Sánchez-Zapata P. Analysis of complications after Whipple’s procedure using ERAS protocols. Colomb. J. Anesthesiol. [Internet]. 2019Oct.1 [cited 2021Jan.26];47(4):219-25. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/27

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Published
2019-10-01
How to Cite
1.
Aristizabal-Linares JP, Estrada-Quiroz JJ, Hoyos-Gómez C, Dávila-Martínez DF, Palacios-Rodríguez OG, Sánchez-Zapata P. Analysis of complications after Whipple’s procedure using ERAS protocols. Colomb. J. Anesthesiol. [Internet]. 2019Oct.1 [cited 2021Jan.26];47(4):219-25. Available from: https://www.revcolanest.com.co/index.php/rca/article/view/27
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