{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T05:17:20Z","timestamp":1781932640161,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,2,16]],"date-time":"2021-02-16T00:00:00Z","timestamp":1613433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypocapnia has been traditionally advocated during general anesthesia, even though it may induce deleterious physiological effects that result in unfavorable outcomes in patients. This study investigated the association between intraoperative end\u2010tidal carbon dioxide (EtCO<jats:sub>2<\/jats:sub>) and length of hospital stay (LOS) in patients who underwent pylorus\u2010preserving pancreaticoduodenectomy (PPPD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The medical records of 759 patients from 2006 to 2015 were reviewed. The patients were divided into two groups based on the mean EtCO<jats:sub>2<\/jats:sub> value during general anesthesia: the hypocapnia group (&lt;\u200935\u00a0mmHg) and the normocapnia group (\u2265\u200935\u00a0mmHg). The primary outcome was LOS between the groups. Secondary outcomes included the length of intensive care unit (ICU) stay, postoperative 30\u2010day, 1\u2010year, and 2\u2010year mortality, and perioperative factors associated with LOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 727 patients were finally analyzed. The median LOS of the hypocapnia group was significantly longer than that of the normocapnia group (22\u00a0days vs. 18\u00a0days, respectively; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Postoperative mortality did not differ between the groups. Cox regression analysis revealed that hypocapnia was an independent risk factor for longer LOS (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.37\u20131.89; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Age and postoperative pancreatic fistula were also risk factors for a longer LOS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>It was concluded that low levels of intraoperative EtCO<jats:sub>2<\/jats:sub> during general anesthesia were associated with an increased LOS for patients undergoing PPPD.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-021-05984-x","type":"journal-article","created":{"date-parts":[[2021,2,19]],"date-time":"2021-02-19T07:25:38Z","timestamp":1613719538000},"page":"1860-1867","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Correlation of Intraoperative End\u2010Tidal Carbon Dioxide Concentration on Postoperative Hospital Stay in Patients Undergoing Pylorus\u2010Preserving Pancreaticoduodenectomy"],"prefix":"10.1002","volume":"45","author":[{"given":"Ji\u2010Hoon","family":"Park","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine Keimyung University Dongsan Medical Center 1095 Dalgubeol\u2010daero, Dalseo\u2010gu 42601 Daegu Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hye\u2010Mi","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Republic of Korea"},{"name":"Anesthesia and Pain Research Institute Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang Moo","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Republic of Korea"},{"name":"Yonsei Cancer Center Pancreatobiliary Cancer Clinic, Severance Hospital 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung Sub","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine Gangnam Severance Hospital 211 Eonju\u2010ro, Gangnam\u2010gu 06273 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chul Ho","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine Gangnam Severance Hospital 211 Eonju\u2010ro, Gangnam\u2010gu 06273 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ho Kyoung","family":"Hwang","sequence":"additional","affiliation":[{"name":"Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Republic of Korea"},{"name":"Yonsei Cancer Center Pancreatobiliary Cancer Clinic, Severance Hospital 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeong\u2010Rim","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Medicine Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Republic of Korea"},{"name":"Anesthesia and Pain Research Institute Yonsei University College of Medicine 50\u20101 Yonsei\u2010ro, Seodaemun\u2010gu 03722 Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,16]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"CD006053","article-title":"Pylorus\u2010preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical treatment of periampullary and pancreatic carcinoma","volume":"2","author":"Huttner 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