The impact of fluid intervention on complications and length of hospital stay after pancreaticoduodenectomy (Whipple’s procedure)

Table 1 Summary of number of patients undergoing pancreaticoduodenectomy with complications

Total patients undergoing pancreaticoduodenectomy	150
Patients with complications	86(57%)
Clavien classification i	5(3%)
ii	41(27%)
iii	25(17%)
iv	11(7%)
v	3(2%)
Post operative pancreatic fistula^a	13(9%)
Grade A	-
Grade B	4(3%)
Grade C	9(6%)
Bile leak^b	6(4%)
Acute pancreatitis^c	8(5%)
Delayed gastric emptying^d	25(17%)
Postoperative bleeding^e	3(2%)
Sepsis^f	33(22%)
Pulmonary edema^g	9(6%)
Myocardial infarction^h	12(8%)
Cardiac arrythmiasⁱ	19(13)
Respiratory failure^j	12(8%)
Pulmonary congestion^k	15(10%)
Pneumonia^l	26(17%)
Renal failure^m	11(7%)
Urinary tract infectionⁿ	4(3%)
Postoperative delerium^o	6(4%)
Patient outcomes
Return to theatre	11(7%)
Unexpected return to intensive care unit	8(5%)
Medical emergency/response call	15(10%)
Death within 30 days	3(2%)

Data presented as number (%).
^aInternational Study Group of Pancreatic Fistula (ISGPF).
^bPresence of bile in the drainage fluid that persisted on postoperative day 4.
^cElevations in serum lipase > 3× normal laboratory reference range.
^dInternational Study Group of Pancreatic Fistula (ISGPF).
^ePostoperative blood loss requiring a blood transfusion.
^fSurviving sepsis campaign: international guidelines definition.
^gRadiological features of acute pulmonary edema requiring medical intervention.
^hECG changes with myocardial enzyme elevation.
ⁱNew onset atrial fibrillation or ventricular arrhythmia requiring medical treatment or cardioversion.
^jProlonged ventilation or reintubation or PaO₂ ≤ 50 mmHg or PaCO₂ ≥ 50 mmHg (room air).
^kShortness of breath with crepitations and desaturation requiring medical intervention.
^lElevated temperature with radiographic pulmonary changes.
^mRise in serum creatinine (absolute increase in serum creatinine of ≥ 0.3 mg/dl (≥ 26.4 μmol/l) or percentage increase in serum creatinine of ≥ 50%) or oliguria (urine output < 0.5 ml/kg/h for more than 6 hours).
ⁿPositive urine culture for pathogens requiring antibiotics.
^oImpaired cognition, fluctuating level of consciousness with altered psychomotor activity not related to emergence from anesthesia or an identifiable etiology.

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