Association of preoperative obstructive jaundice with postoperative infectious complications following pancreaticoduodenectomy.

BACKGROUND/AIMS: The aim of this study was to evaluate the effects of obstructive jaundice on Infectious Complications of the patients who underwent pancreaticoduodenectomy. METHODOLOGY: One-hundred and sixteen consecutive patients without preoperative biliary drainage underwent pancreaticoduodenectomy from January 2006 to April 2010 and their data of post-operative complication were analyzed. Different level of bilirubin and different times of jaundice on infectious complications of the patients underwent pancreaticoduodenectomy were analysis. RESULTS: Patients with severe jaundice (Total bilirubin ≥5 mg/dL; n = 55), had a higher incidence in subsequent infectious complications than the patients with total bilirubin level of less than 5 mg/dL (n = 61) (36.06% vs. 56.36%, p <0.05). The patients with preoperative TB level of 5 or more sub classified according to the duration of jaundice. However, two groups without statistical significance in terms of post-operative complications. There were no significant differences in post-operative mortality rate among the different groups. CONCLUSIONS: The elevated serum bilirubin increases the rate of infectious complications of the patients underwent pancreaticoduodeneotomy.

The effect of intraoperative fluid volume administration on pancreatic fistulas after pancreaticoduodenectomy.

BACKGROUND: Fluid therapy may be one of the most controversial topics in perioperative management. However, data concerning the influence of perioperative fluid administration on complications after pancreaticoduodenectomy are sparse. METHODS: A group of 147 patients underwent pancreaticoduodenectomy for benign or malignant pathology of the pancreas or the periampullary region between 2005 and 2009. Clinical data, overall morbidity, and long-term outcomes were recorded. RESULTS: We categorized the patients into two groups according to intraoperative fluid volume administration: a low fluid volume group (LFVG, <8.2 ml kg(-1) hr(-1), n = 90) group, and a high fluid volume group (HFVG, ≥8.2 ml kg(-1) hr(-1), n = 57). In terms of colloid administration, the high fluid volume group received significantly more colloid both during the intraoperative period and 0-12 hr after surgery (p < .001 and p < .007, respectively). Pancreatic fistula rates were significantly greater in the high fluid volume group (p = .035). However, the long-term survival rate was not different between the two groups. CONCLUSIONS: High intraoperative fluid volume administration is associated with an increased incidence of pancreatic fistulas after pancreaticoduodenectomy.