Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients

Yo Ichi Yamashita, Ken Shirabe, Eiji Tsujita, Kazuki Takeishi, Tetsuo Ikeda, Tomoharu Yoshizumi, Yoshinari Furukawa, Teruyoshi Ishida, Yoshihiko Maehara

Research output: Contribution to journalArticlepeer-review

12 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)539-545
Number of pages7
JournalLangenbeck's Archives of Surgery
Volume398
Issue number4
DOIs
Publication statusPublished - Apr 2013

All Science Journal Classification (ASJC) codes

  • Surgery

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