RESUMO
INTRODUCTION: Optimal fluid balance is critical to minimize anastomotic edema in patients undergoing pancreaticoduodenectomy. We examined the effects of decreased fluid administration on rates of postoperative pancreatic leak and delayed gastric emptying. METHODS: Retrospective study of 105 patients undergoing pancreaticoduodenectomy at a single institution from January 2015 through July 2016. Stroke volume variation (SVV) was tracked and titrated during the procedure. A comparative analysis of postoperative complications was performed between patients with a median SVVâ¯<â¯12 during the extirpative and reconstructive phases of the procedure compared with patients with an SVVâ¯≥â¯12. RESULTS: Of 64 patients who met selection criteria, 42 (65.6%) had a SVVâ¯<â¯12 and 22 (34.4%) had a SVVâ¯≥â¯12. Patients with an SVVâ¯≥â¯12 during the extirpative phase of the procedure had lower rates of postoperative pancreatic leaks compared to patients with an SVVâ¯<â¯12 (5.9% vs 21.3%)). Patients with an SVVâ¯≥â¯12 during the extirpative phase had lower rates of postoperative delayed gastric emptying compared to patients with an SVVâ¯<â¯12 (41.2% vs 46.8%). CONCLUSION: Goal-directed fluid restriction before the reconstructive phase of pancreaticoduodenectomy may contribute to lower postoperative rates of pancreatic leak and delayed gastric emptying.