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

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.

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.

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).

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.