gms | German Medical Science

Introduction: Introduction

In the last decades morbidity and mortality after partial pancreatoduodenectomy (PD) have decreased in most large centres. Yet PD remains a procedure with a relevant perioperative risk. Given the increasing number of elderly patients this study aims to evaluate the mortality and morbidity of patients aged 80 and above after PD.

Material and methods: Material and Methods

Retrospective analysis of all patients who underwent PD at the University Medical Centre Mannheim between January 2000 and December 2010 from a prospective database. We compared perioperative and follow-up details of patients aged 80 or above with those of patients younger than 80 using SPSS.

Results: Results

398 patients underwent PD. 372 patients were younger than 80 years (64±12, median±SD) and 26 were 80 years or above (83±1). Both groups were comparable with respect to indication for resection, ASA status, comorbidities, BMI, presence of jaundice, level of bilirubin, and presence of preoperatively placed TPCD. The only significant difference was that the elderly patients less frequently had weight loss prior to surgery.

There were no significant differences in kind of procedure (Whipple/Traverso), duration of surgery, and estimated blood loss between both groups. There were also no significant differences in postoperative mortality (4% versus 7%) and morbidity (surgical revision, pancreatic fistula, delayed gastric emptying, urinary tract infection, haemorrhage, pneumonia, surgical site infection).

On multivariate analysis risk factors for the incidence of any complications were ASA status, preoperative weight loss, and duration of surgery, but not age.

Conclusion: Conclusions

Clinical outcomes after pancreatoduodenectomy were similar in patients below and above 80 years of age at our institution. If indicated, PD should always be considered even in patients above 80.