Systematic Review and Meta-analysis of Restrictive Perioperative Fluid Management in Pancreaticoduodenectomy

World Journal of Surgery
Brian P ChenGuillaume Martel

Abstract

There is significant interest and controversy surrounding the effect of restrictive fluid management on outcomes in major gastrointestinal surgery. This has been most studied in colorectal surgery, although the literature relating to pancreaticoduodenectomy (PD) patients is growing. The aim of this paper was to generate a comprehensive review of the available evidence for restrictive perioperative fluid management strategies and outcomes in PD. MEDLINE/PubMed, Embase, and the Cochrane Library were searched from inception to April 2017. A review protocol was utilized and registered with PROSPERO. Primary citations that evaluated perioperative fluid management in PD, including those as part of a clinical pathway, were considered. The primary outcome was postoperative pancreatic fistula (POPF). Secondary outcomes included delayed gastric emptying (DGE), complication rate, length of stay (LOS), mortality, and readmission. A total of six studies involving 846 patients were included (2009-2015), of which four were RCTs. Pooled analysis of RCTs and high-quality observational studies found no effect of restrictive intraoperative fluid management on POPF, DGE, complication rate, LOS, mortality, and readmission. Only one study assessed p...Continue Reading

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Citations

Jun 20, 2019·Minerva anestesiologica·Nicola BrienzaLuigi Tritapepe
Sep 3, 2020·World Journal of Gastroenterology : WJG·In Woong HanBaek Hwan Cho
Oct 13, 2020·Zentralblatt für Chirurgie·Steffen DeichmannDirk Bausch
Nov 26, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Natalia Paez ArangoChing-Wei D Tzeng
May 1, 2021·Journal of Clinical Medicine·Madhivanan Elango, Vassilios Papalois

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