Randomized Trial of Restrictive Versus Liberal Perioperative Fluid Management for Patients Undergoing Pancreatic Resection

A Prospective Randomized Controlled Clinical Trial of Restrictive Versus Liberal Perioperative Fluid Management for Patients Undergoing Pancreatic Resection

The purpose of this study is to help us learn what the best amount of fluid is that patients should receive during pancreas surgery. Patients will receive either the liberal fluid amount for this surgery or a restricted fluid amount.

Both amounts of fluid have been used safely in patients having similar surgeries. These amounts have not been compared in pancreatic surgery. The fluids regimens that will be given are not experimental.

This study will compare patients in the liberal and restricted fluid groups in terms of the nature of any surgical complications (problems)and recovery from surgery, including length of hospital stay.

Inclusion Criteria:

• Adults > or = 18 years
• Patients scheduled for Pancreaticoduodenectomy, Central Pancreatectomy or Distal Pancreatectomy.

Exclusion Criteria:

• Pregnancy
• History of active coronary disease unless a cardiac stress test showing no reversible ischemia and normal LV function within 30 days of operation
• MI within 3 months
• History of stroke
• History of congestive heart failure and ejection fraction less than 35%
• History of severe COPD and resting oxygen saturation (SpO2) < 90%
• Renal dysfunction (Cr > 1.8)
• Abnormal coagulation parameters (INR > 1.5 not on Coumadin, or platelet
• Presence of active infection including HIV
• BMI > 35
• American Society of Anesthesiologists Status > III, assigned at time of preoperative visit
• Corticosteroid use > 10 mg Prednisone/day
• Bilirubin > 10.0