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Changes in Serum Lactate Level Predict Postoperative Intra-Abdominal Infection After Pancreatic Resection

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Abstract

Objective

Postoperative intra-abdominal infection is one of the most serious complications after pancreatic resection. In this article, we investigated the relationship between serum lactate level and postoperative infection, to suggest a new predictor of potential infection risk after pancreatectomy.

Methods

A retrospective analysis of 156 patients who underwent pancreatic surgery and admitted in the intensive care unit for recovery after surgery between August 2017 and August 2019 was performed.

Results

The basic characteristics, preoperative information, pathological diagnoses, surgical methods, and intraoperative situations of patients in the postoperative intra-abdominal infection group (n = 52) and non-infection group (n = 104) showed no significant differences. With the same postoperative treatments and results of fluid balance, blood pressure maintenance, and laboratory tests, postoperative serum lactate level increased much higher in the infection group than non-infection group (P < 0.001), while the base excess level declined much lower (P = 0.002). Patients in the infection group needed more time to elute lactate (P < 0.001), and stayed longer in the intensive care unit after surgery (P = 0.007). The overall postoperative complications were certainly more in the infection group (P < 0.001), resulting in a longer hospitalization time (P < 0.001).

Conclusions

When patients recovered smoothly from anesthesia with a stable hemodynamics situation and normal results of laboratory tests, abnormally high serum lactate level could be a predictor of postoperative intra-abdominal infection after pancreatic resection.

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Funding

This work was supported by the project of Capital’s Funds for Health Improvement and Research (2020-1-4011), and the project of application and promotion of capital special clinical research from Beijing Municipal Science & Technology Commission (Z171100001017017018).

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Authors and Affiliations

  1. Department of General Surgery, Peking Union Medical College Hospital, Beijing, 100730, China

    Yatong Li, Lixin Chen, Cheng Xing, Cheng Ding, Hanyu Zhang, Shunda Wang, Junchao Guo, Quan Liao, Taiping Zhang, Yupei Zhao & Menghua Dai

  2. Department of Intensive Care Unit, Peking Union Medical College Hospital, Beijing, China

    Yun Long

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  1. Yatong Li
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Contributions

YL and LC are the co-first authors of this article, who took in charge of data collection, analysis, article writing and language editing; CX, CD, HZ, and SW helped to collect data; MD is the correspondence author of this article, who guided the whole work, while YZ, YL, JG, QL, and TZ helped to conduct the research.

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Correspondence to Menghua Dai.

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Yatong Li and Lixin Chen are co-first authors.

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Li, Y., Chen, L., Xing, C. et al. Changes in Serum Lactate Level Predict Postoperative Intra-Abdominal Infection After Pancreatic Resection. World J Surg 45, 1877–1886 (2021). https://doi.org/10.1007/s00268-021-05987-8

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