Lana Othman Mahmmud , Vilhelmas Bartusevicius , Åke Norberg , Poya Ghorbani , Jonathan Grip
{"title":"胰腺手术后乳酸升高的频率及其与术后并发症的关系","authors":"Lana Othman Mahmmud , Vilhelmas Bartusevicius , Åke Norberg , Poya Ghorbani , Jonathan Grip","doi":"10.1016/j.sipas.2025.100298","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Lactate is often elevated following major pancreatic surgery but the clinical relevance of this it not known.</div></div><div><h3>Methods</h3><div>A retrospective study including 491 consecutive patients undergoing major pancreatic surgery. Lactate upon arrival to post anaesthesia unit (L<sub>0</sub>), the morning following surgery (L<sub>POD1</sub>) and the highest value within those two time points (L<sub>High</sub>) were examined. The primary outcome was postoperative complications (Clavien-Dindo IIIa-V) and the secondary outcomes were surgery specific complications and hospital length of stay.</div></div><div><h3>Results</h3><div>Median lactate values were: L01.7 mmol/L (IQR: 1.2 –2.6), LPOD11.3 mmol/L (IQR: 0.9 –1.9) and L<sub>High</sub> 2.3 mmol/L (IQR 1.7 –3.1). There were no differences in lactate values at any measuring point between those developing complications and those that didn´t. AUROC analysis (0.531–0.581) and Youden´s index (0.08–0.17) indicated poor diagnostic performance. L<sub>High</sub> > 2.65 mmol/L was associated with Odds ratio 2.05 (1.34 –3.14) for developing postoperative complications. Plasma lactate was higher following total pancreatectomy compared to partial resection at all three time points.</div></div><div><h3>Discussion</h3><div>Plasma lactate elevation in common following pancreatic surgery; however, this is of limited clinical use to predict complications. The relatively higher lactate following total pancreatectomy might be due to hormonal deficits inherent to this procedure.</div></div>","PeriodicalId":74890,"journal":{"name":"Surgery in practice and science","volume":"22 ","pages":"Article 100298"},"PeriodicalIF":0.8000,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Frequency of lactate elevation following pancreatic surgery and its relationship to postoperative complications\",\"authors\":\"Lana Othman Mahmmud , Vilhelmas Bartusevicius , Åke Norberg , Poya Ghorbani , Jonathan Grip\",\"doi\":\"10.1016/j.sipas.2025.100298\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Lactate is often elevated following major pancreatic surgery but the clinical relevance of this it not known.</div></div><div><h3>Methods</h3><div>A retrospective study including 491 consecutive patients undergoing major pancreatic surgery. Lactate upon arrival to post anaesthesia unit (L<sub>0</sub>), the morning following surgery (L<sub>POD1</sub>) and the highest value within those two time points (L<sub>High</sub>) were examined. The primary outcome was postoperative complications (Clavien-Dindo IIIa-V) and the secondary outcomes were surgery specific complications and hospital length of stay.</div></div><div><h3>Results</h3><div>Median lactate values were: L01.7 mmol/L (IQR: 1.2 –2.6), LPOD11.3 mmol/L (IQR: 0.9 –1.9) and L<sub>High</sub> 2.3 mmol/L (IQR 1.7 –3.1). There were no differences in lactate values at any measuring point between those developing complications and those that didn´t. AUROC analysis (0.531–0.581) and Youden´s index (0.08–0.17) indicated poor diagnostic performance. L<sub>High</sub> > 2.65 mmol/L was associated with Odds ratio 2.05 (1.34 –3.14) for developing postoperative complications. Plasma lactate was higher following total pancreatectomy compared to partial resection at all three time points.</div></div><div><h3>Discussion</h3><div>Plasma lactate elevation in common following pancreatic surgery; however, this is of limited clinical use to predict complications. The relatively higher lactate following total pancreatectomy might be due to hormonal deficits inherent to this procedure.</div></div>\",\"PeriodicalId\":74890,\"journal\":{\"name\":\"Surgery in practice and science\",\"volume\":\"22 \",\"pages\":\"Article 100298\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-07-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgery in practice and science\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666262025000270\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgery in practice and science","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666262025000270","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
Frequency of lactate elevation following pancreatic surgery and its relationship to postoperative complications
Background
Lactate is often elevated following major pancreatic surgery but the clinical relevance of this it not known.
Methods
A retrospective study including 491 consecutive patients undergoing major pancreatic surgery. Lactate upon arrival to post anaesthesia unit (L0), the morning following surgery (LPOD1) and the highest value within those two time points (LHigh) were examined. The primary outcome was postoperative complications (Clavien-Dindo IIIa-V) and the secondary outcomes were surgery specific complications and hospital length of stay.
Results
Median lactate values were: L01.7 mmol/L (IQR: 1.2 –2.6), LPOD11.3 mmol/L (IQR: 0.9 –1.9) and LHigh 2.3 mmol/L (IQR 1.7 –3.1). There were no differences in lactate values at any measuring point between those developing complications and those that didn´t. AUROC analysis (0.531–0.581) and Youden´s index (0.08–0.17) indicated poor diagnostic performance. LHigh > 2.65 mmol/L was associated with Odds ratio 2.05 (1.34 –3.14) for developing postoperative complications. Plasma lactate was higher following total pancreatectomy compared to partial resection at all three time points.
Discussion
Plasma lactate elevation in common following pancreatic surgery; however, this is of limited clinical use to predict complications. The relatively higher lactate following total pancreatectomy might be due to hormonal deficits inherent to this procedure.