Association Between Intraoperative Hypothermia and Postoperative Pancreatic Fistula

Area of Science:

• Surgical Oncology
• Gastroenterology
• Critical Care Medicine

Background:

• Intraoperative hypothermia is a frequent complication in abdominal surgery, potentially worsening patient outcomes.
• The specific impact of hypothermia during pancreaticoduodenectomy (PD) on postoperative pancreatic fistula (POPF) development is not well-established.

Purpose of the Study:

• To investigate the incidence of intraoperative hypothermia in patients undergoing open PD.
• To determine the association between intraoperative hypothermia and the development of POPF.

Main Methods:

• Retrospective analysis of 374 patients who underwent open PD between January 2018 and March 2024.
• Intraoperative hypothermia defined as core temperature < 36.0 °C.
• Multivariable logistic regression used to assess factors associated with hypothermia and POPF.

Main Results:

• Hypothermia occurred in 78.3% of patients; 9.6% developed clinically relevant POPF.
• Hypothermia was independently associated with an increased risk of POPF (OR 3.4; p=0.044).
• Factors associated with POPF included higher BMI, nonpancreatic ductal adenocarcinoma, and recent PD procedures.

Conclusions:

• Intraoperative hypothermia is prevalent in open PD and is a significant risk factor for POPF.
• Further research is required to standardize hypothermia definitions and explore its link to specific surgical complications.