Abstract
Background
There are conflicting data on the risk of postoperative pancreatic fistula (POPF)
associated with postoperative NSAID use. The primary objective of this multi-center
retrospective study was to assess the relationship between ketorolac use and POPF.
The secondary objective was to assess for effect of ketorolac use on overall complication
rate.
Methods
Retrospective chart review of patients undergoing pancreatectomy from January 1, 2005–January
1, 2016 was performed. Data on patient factors (age, sex, comorbidities, previous
surgical history etc.), operative factors (surgical procedure, estimated blood loss,
pathology etc.), and outcomes (morbidities, mortality, readmission, POPF) were collected.
The cohort was compared based on ketorolac use.
Results
The study included 464 patients. Ninety-eight (21%) patients received ketorolac during
the study period. Ninety-six (21%) patients were diagnosed with POPF within 30 days.
There was a significant association between ketorolac use and clinically relevant
POPF (21.4 vs. 12.7%) (p = 0.04, 95% CI [1.76, 1.04–2.97]). There was no significant
difference in overall morbidity or mortality between the groups.
Discussion
Though there was no overall increase in morbidity, there was a significant association
between POPF and ketorolac use. The use of ketorolac after pancreatectomy should be
judicious.
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Article info
Publication history
Published online: February 09, 2023
Accepted:
February 6,
2023
Received:
July 18,
2022
Publication stage
In Press Corrected ProofFootnotes
This article is being submitted as an original article. It is based on a podium presentation by A. Adkins at Pacific Coast Surgical Association Annual Meeting- Napa Valley, CA. February 2018.
Identification
Copyright
Published by Elsevier Ltd on behalf of International Hepato-Pancreato-Biliary Association Inc.
