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Laparoscopic pancreaticoduodenectomy in elderly patients

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Abstract

Objective

The objective of the study is to evaluate the safety and feasibility of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients by short-term surgical effects.

Methods

We retrospectively collected clinical data of 55 non-elderly patients (< 70 years), 27 elderly patients (≥ 70 years) underwent LPD, and 19 elderly patients underwent open pancreaticoduodenectomy (OPD) in biliopancreatic surgery department of Huadong Hospital, affiliated to Fudan University, from Jan 2015 to Jan 2018. Patients were divided into 3 groups: LPD aged < 70 years, LPD aged ≥ 70 years, and OPD aged ≥ 70 years, according to their age at admission and surgical approach in order to compare baseline characteristics and short-term surgical outcomes.

Results

Totally 101 patients were included in this study; 59 cases were male; 42 cases were female; mean age was 66 years old. Elderly LPD patients seemed to have higher overall morbidity (41% vs. 20%, P = 0.05) compared to non-elderly patients. This difference is even more significant in our multivariable analysis model with an odds ratio of 4.48 (95% CI 1.31–17.87, P = 0.018). The 90-days mortality, operative time, estimated blood loss (EBL), and post-operative hospital stay (POHS) were similar in two groups. Elderly LPD patients had less EBL and shorter POHS than elderly OPD patients. However, the mortality and morbidity rate were comparable in these two groups.

Conclusions

Aging patients have higher overall morbidity than younger patients in LPD. However, for aging population who need to undergo pancreaticoduodenectomy, LPD might have some advantages over OPD.

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Author notes

  1. Liting Zhao and Chongyi Jiang have contributed equally to this article.

Authors and Affiliations

  1. Department of General Surgery, Huadong Hospital, Fudan University, West 221 Yan-an Road, Shanghai, 200040, China

    Yun Liang, Chongyi Jiang, Pengfei Hu, Hongwei Wang & Zhiwei Cai

  2. Department of Biliopancreatic Surgery, Huadong Hospital, Fudan University, West 221 Yan-an Road, Shanghai, 200040, China

    Liting Zhao & Wei Wang

Authors
  1. Yun Liang
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  2. Liting Zhao
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  3. Chongyi Jiang
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  4. Pengfei Hu
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  5. Hongwei Wang
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  7. Wei Wang
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Correspondence to Chongyi Jiang or Wei Wang.

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Drs. Yun Liang, Liting Zhao, Zhiwei Cai, Pengfei Hu, Hongwei Wang, Chongyi Jiang, and Wei Wang have no conflicts of interest or financial ties to disclose.

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Liang, Y., Zhao, L., Jiang, C. et al. Laparoscopic pancreaticoduodenectomy in elderly patients. Surg Endosc 34, 2028–2034 (2020). https://doi.org/10.1007/s00464-019-06982-w

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