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Is age a barrier to pancreaticoduodenectomy? An Italian dual-institution study

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Abstract

The aim of this study is to evaluate the role of age after pancreaticoduodenectomy. This is a retrospective study of 223 patients who underwent pancreaticoduodenectomy for periampullary diseases. Three age groups of patients were compared: ≤70 years of age (group A); between 71 and 79 years of age (group B) and 80 years of age or older (group C). The primary endpoint was the postoperative mortality rate. Secondary endpoints were the overall postoperative morbidity, postoperative pancreatic fistula, postoperative pancreatic haemorrhage, bile leakage, delayed gastric emptying rates, the length of hospital stay, intensive care unit stay, the type of discharge from hospital, reoperation rate and overall survival. Uni-multivariate analyses and Kaplan–Meier curve were carried out. At univariate analysis, only the type of discharge from hospital showed that group B and C patients required a period of rehabilitation more frequently than group A (P = 0.047 and P < 0.001, respectively). Multivariate analysis confirmed that age was not related to postoperative mortality (P = 0.258), morbidity (P = 0.912) and overall survival (P = 0.658), but it was related to type of discharge (P < 0.001). The present study seems to suggest that a pancreaticoduodenectomy is a feasible and safe procedure, even in elderly and very elderly patients even if the latter require a longer period of rehabilitation.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti N.9, 40138, Bologna, Italy

    Riccardo Casadei, Giovanni Taffurelli, Claudio Ricci & Francesco Minni

  2. Department of Surgery, San Giovanni Battista, Molinette Hospital, Turin, Italy

    Stefano Silvestri & Donata Campra

Authors
  1. Riccardo Casadei
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  2. Giovanni Taffurelli
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  3. Stefano Silvestri
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  4. Claudio Ricci
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  5. Donata Campra
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  6. Francesco Minni
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Correspondence to Riccardo Casadei.

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No commercial interest, financial source or material support to disclose.

Conflict of interest

Riccardo Casadei and the other co-authors have no conflict of interest.

Ethical standard

All procedures performed in the study involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

Research involving human participants and/or animals

Riccardo Casadei and the other co-authors have not performed research involving human participants and/or animals.

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In all patients included in the study, informed consent was obtained.

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Casadei, R., Taffurelli, G., Silvestri, S. et al. Is age a barrier to pancreaticoduodenectomy? An Italian dual-institution study. Updates Surg 67, 439–447 (2015). https://doi.org/10.1007/s13304-015-0337-9

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  • DOI: https://doi.org/10.1007/s13304-015-0337-9

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