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Safety and Efficacy of Pancreaticoduodenectomy in Octogenarians

Authors :
Yeqian Huang
Ramesh Damodaran Prabha
Terence C. Chua
Jennifer Arena
Krishna Kotecha
Anubhav Mittal
Anthony J. Gill
Jaswinder S. Samra
Source :
Frontiers in Surgery, Vol 8 (2021)
Publication Year :
2021
Publisher :
Frontiers Media S.A., 2021.

Abstract

Backgrounds: Pancreaticoduodenectomy (PD) remains the only hope of a cure in selected patients with pancreatic adenocarcinoma (PAC). With an aging population, there will be an increasing number of very elderly patients being diagnosed with PAC of whom a selected proportion would be suitable for PD. However, the literature on outcomes of elderly patients after PD remains ambiguous. Therefore, the aim of this study was to examine the safety and efficacy of PD in octogenarians with PAC.Methods: A retrospective analysis of 304 patients with PAC undergoing PD. Patients were divided into two age groups using age of 80 years old as the cut-off.Results: Overall mortality and major morbidity rates were 0.5 and 18.5%, respectively. The octogenarian group had a higher rate of mortality (6.3%, n = 1, p < 0.001), a higher rate of major morbidity (37.5%, n = 6, p = 0.042) and a longer hospital stay (p = 0.035). However, median survival of octogenarians was 15.6 months. Multivariate analysis showed age was not identified as a prognostic factor for major morbidity and overall survival.Conclusion: Age alone should not be an exclusion criterion for consideration of PD. With careful selection, PD can be safely performed in octogenarians. Elderly patients should be referred to a specialized unit for an objective assessment to determine the suitability for this aggressive but potential curative approach.

Details

Language :
English
ISSN :
2296875X
Volume :
8
Database :
Directory of Open Access Journals
Journal :
Frontiers in Surgery
Publication Type :
Academic Journal
Accession number :
edsdoj.58c9584344594528b3a00df941f89711
Document Type :
article
Full Text :
https://doi.org/10.3389/fsurg.2021.617286