HYPA study: protocol for investigating intra-abdominal hypertension and abdominal compartment syndrome in patients undergoing open and robotic pancreatic procedures

Intra-abdominal hypertension and abdominal compartment syndrome are frequently presented in critically ill patients admitted to intensive care units. Patients undergoing pancreatic procedures are susceptible to gastroparesis, postoperative ileus, intra-abdominal collection or extensive fluid resuscitation, all of which are risk factors for elevation of intra-abdominal pressure. This study aims to assess the incidence of intra-abdominal hypertension and abdominal compartment syndrome following pancreatic procedures; explore potential correlations between intra-abdominal hypertension and the development of postoperative complications such as anastomotic dehiscence, pancreatic fistulas, ileus or delayed gastric emptying and compare the occurrence of intra-abdominal hypertension in patients undergoing robotic versus open pancreatic procedures. The HYPA study is a prospective observational study conducted at a high-volume pancreatic centre. Patients admitted to the intensive care unit between 1 January 2025 and 31 December 2027, following pancreatic procedures, will be enrolled. Intra-abdominal pressure will be measured using a standardised protocol during the postoperative intensive care unit stay. The collected data will include perioperative factors such as fluid management, surgical complications and postoperative outcomes, including delayed gastric emptying, pancreatic fistula and infections. Statistical models will analyse correlations between intra-abdominal hypertension, abdominal compartment syndrome and postoperative morbidity. This study aims to provide evidence supporting routine intra-abdominal pressure monitoring in this surgical population, enabling earlier diagnosis and intervention. By evaluating the potential benefits of robotic pancreatic surgery in reducing intra-abdominal hypertension-related complications, the findings could guide future clinical protocols, enhance postoperative outcomes and contribute to the growing evidence supporting minimally invasive pancreatic surgery. Number: NCT06672601 ClinicalTrials.Gov. Date 01.11.2024.