Comparision of intraoperative basal fluid requirements in distal pancreatectomy : laparotomy vs. laparoscopy : A retrospective cohort study

Abstract

Background: There has been recent progress in intraoperative fluid therapy. However, little is known about intraoperative fluid therapy in laparoscopic surgery. The purpose of this study is to determine whether there are differences in the basal fluid requirements during surgery between laparotomy and laparoscopic distal pancreatectomy. Methods: This retrospective cohort study analyzed the electronic medical records of 253 patients who underwent distal pancreatectomy via either laparotomy (73 patients) or laparoscopy (180 patients) between June 2006 and March 2016. The volume of intraoperative fluid administered, postoperative complications, length of hospital stay, and readmission rate were evaluated. The total volume of fluids was calculated as the sum of the volume of crystalloid plus the volume of colloid multiplied by 1.5 or 2.0. Results: More colloid was infused in laparotomy than in laparoscopy (1.5 ml/kg/h vs. 1.0 ml/kg/h, P = 0.007), while there were no significant differences in the volumes of crystalloid (7.6 ml/kg/h vs. 7.2 ml/kg/h, P = 0.578) or total fluids (1.5 times: 9.8 ml/kg/h vs. 8.7 ml/kg/h, P = 0.136

2.0 times: 10.6 vs. 9.1 ml/kg/h, P = 0.092). The hospital stay was longer (18 day vs. 13.4 day, P < 0.001), and the rates of postoperative complications (63% vs. 45%, P = 0.008) and readmission (15% vs. 5.6%, P = 0.02) were higher in laparotomy. Conclusions: In patients undergoing distal pancreatectomy, no significant difference was found in intraoperative basal fluid requirements between laparotomy and laparoscopy.