Correlation between arterial lactic acid level and complications within 30 days postoperatively in elderly patients undergoing pancreaticoduodenectomy
10.3760/cma.j.issn.0254-9026.2022.10.008
- VernacularTitle:老年胰十二指肠切除术患者血乳酸水平与术后早期并发症的关联研究
- Author:
Jie BAO
1
;
Lihong ZHU
;
Dongyuan JIN
;
Shihao WU
;
Hui YU
Author Information
1. 北京医院手术麻醉科 国家老年医学中心 中国医学科学院老年医学研究院，北京 100730
- Keywords:
Pancreaticoduodenectomy;
Lactic acid;
Postoperative complications
- From:
Chinese Journal of Geriatrics
2022;41(10):1173-1177
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the association between arterial lactate levels and complications within 30 days postoperatively in elderly patients undergoing pancreaticoduodenectomy.Methods:Elderly patients undergoing pancreaticoduodenectomy under selective general anesthesia in Beijing Hospital from July 2019 to December 2021 were enrolled.According to whether complications occurred within 30 days after operation, the patients were divided into complication group(C Group)and no complication group(N Group). General clinical data and lactic acid level before and after surgery were compared between the two groups.And the association between lactic acid level and complications within 30 days postoperatively was evaluated.Results:A total of 70 elderly patients were included in this study, of whom 22 patients had complications with proportion of 31.4%(22/70), including 2 cases of hemorrhage(2.9%, 2/70), one case of infection(1.4%, 1/70), 1 case of pneumonedema(1.4%, 1/70), 13 cases of pancreatic fistula(18.6%, 13/70), 5 cases of all-cause death postoperatively(7.1%, 5/70). There was no significant difference in baseline of arterial lactate level between two groups[0.70(0.50, 0.80)mmol/L vs.0.70(0.50, 1.20)mmol/L, Z=-1.150, P=0.250], while the lactate level at the end of the surgery was significantly higher in group C[1.60(0.90, 2.25)mmol/L]than in group N[1.00(0.80, 1.38)mmol/L]( Z=-2.396, P=0.017). The arterial lactate level at the end of the surgery was a risk factor for postoperative complications by multivariate analyses( OR=2.501, 95% CI: 1.154~5.418, P=0.020). Conclusions:Lactate level at the end of the surgery is related to early postoperative complications(within 30 days postoperatively)in elderly patients undergoing pancreaticoduodenectomy.Paying great attention to lactate monitoring at the end of the surgery may reduce the occurrence of perioperative complications in elderly patients undergoing pancreaticoduodenectomy.
