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Purpose <p>This study investigated whether blood loss (BL) was. truly less in patients undergoing laparoscopic pancreaticoduodenectomy (LPD) than in those undergoing open pancreaticoduodenectomy (OPD).</p> Methods <p>A total of 98 patients undergoing pancreaticoduodenectomy between 2021 and 2023 were divided into OPD and LPD groups and compared. Estimated BL was calculated from the perioperative changes in hematocrit, hemoglobin, or red blood cell volume. Actual BL was calculated using the conventional method as the sum of the intraoperative aspirated blood volume and surgical gauze weight.</p> Results <p>Actual BL was significantly lower in the LPD group than in the OPD group (150 [80–350] ml vs. 345 [150–700] ml,<i> p</i> = 0.003). However, there were no significant differences in the estimated BL calculated from the hematocrit (461 [187–626] ml vs. 351 [153–737] ml, <i>p</i> = 0.972), hemoglobin, or red blood cell volume. Estimated BL showed a stronger linear correlation with actual BL in the OPD group (<i>r</i> = 0.447–0.669) than in the LPD group (<i>r</i> = 0.158–0.417). OPD was not a significant factor in the increased estimated BL.</p> Conclusions <p>The conventional method for calculating the BL in LPD may underestimate the actual loss, highlighting the need for a more accurate method of evaluation.</p>

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The conventional method of blood-loss calculation can underestimate true blood loss during laparoscopic pancreaticoduodenectomy: a dual-institute experience

  • 期刊论文

  • 发表日期：

    2025年4月15日

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  • Masashi Tsunematsu,
  • Yoshihiro Shirai,
  • Ryoga Hamura,
  • Koichiro Haruki,
  • Kenei Furukawa,
  • Shinji Onda,
  • Michinori Matsumoto,
  • Norimitsu Okui,
  • Tomohiko Taniai,
  • Toru Ikegami

摘要

Purpose

This study investigated whether blood loss (BL) was. truly less in patients undergoing laparoscopic pancreaticoduodenectomy (LPD) than in those undergoing open pancreaticoduodenectomy (OPD).

Methods

A total of 98 patients undergoing pancreaticoduodenectomy between 2021 and 2023 were divided into OPD and LPD groups and compared. Estimated BL was calculated from the perioperative changes in hematocrit, hemoglobin, or red blood cell volume. Actual BL was calculated using the conventional method as the sum of the intraoperative aspirated blood volume and surgical gauze weight.

Results

Actual BL was significantly lower in the LPD group than in the OPD group (150 [80–350] ml vs. 345 [150–700] ml, p = 0.003). However, there were no significant differences in the estimated BL calculated from the hematocrit (461 [187–626] ml vs. 351 [153–737] ml, p = 0.972), hemoglobin, or red blood cell volume. Estimated BL showed a stronger linear correlation with actual BL in the OPD group (r = 0.447–0.669) than in the LPD group (r = 0.158–0.417). OPD was not a significant factor in the increased estimated BL.

Conclusions

The conventional method for calculating the BL in LPD may underestimate the actual loss, highlighting the need for a more accurate method of evaluation.