Perioperative fluid management in pancreaticoduodenectomy in the era of goal-directed fluid therapy: a review of the literature

Goal-directed fluid therapy protocols offer a promising approach to PD fluid management by individualizing fluid delivery, minimizing complications, and improving perfusion metrics, resulting in a more effective restrictive fluid approach. Despite these advancements, heterogeneity in study designs, fluid management definitions, and monitoring tools limits a clear consensus. Future research should prioritize multicenter randomized controlled trials, standardized protocols, and long-term outcome assessments to refine evidence-based, patient-centered fluid management strategies in PD.