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Published in: Langenbeck's Archives of Surgery 4/2013

01-04-2013 | Original Article

Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients

Authors: Yo-ichi Yamashita, Ken Shirabe, Eiji Tsujita, Kazuki Takeishi, Tetsuo Ikeda, Tomoharu Yoshizumi, Yoshinari Furukawa, Teruyoshi Ishida, Yoshihiko Maehara

Published in: Langenbeck's Archives of Surgery | Issue 4/2013

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Abstract

Backgrounds

Pancreaticoduodenectomy (PD) is an aggressive surgery with considerable operative risks, but offers the only chance for cure in patients with periampullary tumors. A growing number of elderly patients are being offered PD because of the aging of populations in developed countries. We examined surgical outcomes of PD in patients aged 75 years and older (≥75 years).

Methods

A retrospective cohort study was performed in 65 consecutive patients who underwent PD for periampullary tumors at a single medical center during the 5 years from 2006 to 2010. We analyzed surgical outcomes such as mortality and morbidity after PD in patients aged ≥75 years (n = 21) compared to those in patients aged <75 years (n = 44).

Results

The positive rate of comorbidities such as hypertension was significantly higher in patients aged ≥75 years than in patients aged <75 years (76 vs. 48 %; p = 0.03). The incidence of wound infection was significantly higher in patients aged ≥75 years than in patients aged <75 years (19 vs. 0 %; p < 0.01). However, there was no significant difference in the mortality rate (0 vs. 2 %; p = 0.49) or the overall morbidity rate (33 vs. 32 %; p = 0.90). There was no significant difference in changes in body weight or serum albumin levels during the 3 months after PD between the two groups, but the recovery of serum prealbumin levels from 1 to 3 months after PD in patients aged ≥75 years was significantly delayed compared to that in patients aged <75 years (p = 0.04). There was no statistically significant difference in long-term survival between the two groups.

Conclusions

Advanced age alone should not discourage surgeons from offering PD, although nutritional supports after PD for elderly patients aged ≥75 years are needed.
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Metadata
Title
Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients
Authors
Yo-ichi Yamashita
Ken Shirabe
Eiji Tsujita
Kazuki Takeishi
Tetsuo Ikeda
Tomoharu Yoshizumi
Yoshinari Furukawa
Teruyoshi Ishida
Yoshihiko Maehara
Publication date
01-04-2013
Publisher
Springer-Verlag
Published in
Langenbeck's Archives of Surgery / Issue 4/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-013-1061-x

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