Pancreaticoduodenectomy can be safely performed in the elderly

Surg Today. 2013 Jun;43(6):620-4. doi: 10.1007/s00595-012-0383-6. Epub 2012 Oct 27.

Abstract

Background: Although pancreaticoduodenectomy has been recognized in the past for its severe complications, improvements in operative methods and perioperative management have made it a safe procedure. Therefore, pancreaticoduodenectomy can be performed in elderly patients, and our experience and outcomes are described in this report.

Methods: We retrospectively investigated 142 patients in whom pancreaticoduodenectomy was performed without stenting tubes during pancreaticojejunostomy. The patients were classified into two groups: (A) those older and (B) younger than 75 years. The outcomes, including preoperative characteristics, intraoperative characteristics, postoperative complications and mortality, are herein reported. Continuous variables were compared using Student's t test and the Chi-square test.

Results: There were no differences between groups A and B in terms of sex, operative time, amount of blood loss, performance status, soft pancreas rate, disease distribution and operative procedure. Comorbidities in groups A and B were statistically different. Regarding the preoperative status, the elderly patients exhibited lower serum albumin and hemoglobin levels than the younger patients. There were no differences in mortality (0 vs. 0 %), morbidity (24.3 vs. 29.5 %, p = 0.362), postoperative hospital days or major complications such as pancreatic fistula development, delayed gastric emptying, intra-abdominal abscess development, biliary fistula formation and postpancreatectomy hemorrhage.

Conclusions: Pancreaticoduodenectomy can be safely performed in elderly as well as younger patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aging*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Fistula / prevention & control
  • Pancreatic Neoplasms / surgery
  • Pancreaticojejunostomy / methods*
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Risk Factors
  • Stents
  • Treatment Outcome
  • Young Adult