Langenbeck's Archives of Surgery

, Volume 398, Issue 4, pp 539–545

Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients

Authors

    • Department of SurgeryHiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
    • Department of Surgery and Science, Graduate School of Medical SciencesKyushu University
  • Ken Shirabe
    • Department of Surgery and Science, Graduate School of Medical SciencesKyushu University
  • Eiji Tsujita
    • Department of SurgeryHiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Kazuki Takeishi
    • Department of SurgeryHiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Tetsuo Ikeda
    • Department of Surgery and Science, Graduate School of Medical SciencesKyushu University
  • Tomoharu Yoshizumi
    • Department of Surgery and Science, Graduate School of Medical SciencesKyushu University
  • Yoshinari Furukawa
    • Department of GastroenterologyHiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Teruyoshi Ishida
    • Department of SurgeryHiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital
  • Yoshihiko Maehara
    • Department of Surgery and Science, Graduate School of Medical SciencesKyushu University
Original Article

DOI: 10.1007/s00423-013-1061-x

Cite this article as:
Yamashita, Y., Shirabe, K., Tsujita, E. et al. Langenbecks Arch Surg (2013) 398: 539. doi:10.1007/s00423-013-1061-x

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.

Keywords

Pancreaticoduodenectomy (PD)Elderly patientsMortality and morbidityWound infectionPrealbumin

Copyright information

© Springer-Verlag Berlin Heidelberg 2013