Pancreatic surgery in elderly patients
© Prati et al; licensee BioMed Central Ltd. 2010
Published: 19 May 2010
Elderly pts are at a greater risk of post-operative complications than younger ones, due to several pre-existing co-morbidities.
Nevertheless, in recent years, improvements in surgical techniques and mainly in anesthesiology have allowed successful treatments also in elderly people.
Materials and methods
122 pts (M: 65; F: 57), over 70 years of age, affected with pancreatic pathologies, were considered. Pre-existing co-morbidities were mainly represented by: hypertension, chronic obstructive pulmonary disease, diabetes mellitus, coronary artery disease, cardiac valve disease.
Percutaneous and or endoscopic US-guided biopsy of the pancreas for histopathologic demonstration of cancer before surgery or chemotherapy was always performed.
88 pts suffered from cancer of the pancreas; 6 from benign tumors of the pancreas; 26 from pancreatitis; 1 from cancer of the transverse colon infiltrating the pancreas and the stomach and 1 from cancer of the stomach infiltrating the head of the pancreas.
92 pts underwent surgery and were thus divided: 67 for cancer, 7 for benign pathologies and 18 for pancreatitis; 53 pts underwent pancreatic resections and were thus divided: 1 total pancreatectomy, 10 distal splenopancreatectomies, 19 pancreaticoduodenectomies, 23 partial resections. 24 pts underwent surgical palliation for unresectable cancer, conditioning obstructive jaundice and or duodenal obstruction. 3 pts underwent intraoperative biopsy.
25 pts with obstructive jaundice, underwent ERCP, with positioning of endo-luminal stent before surgery or before chemotherapy (if resective surgery was contraindicated). After resective surgery of the pancreas, mean post-operative ICU stay and mean post-operative hospital stay were 7 and 20 days respectively; major post-operative complications were registered; 2 pts died in the post-operative period.
The overall outcome of pancreatic surgery in the elderly is acceptable; furthermore if we consider that it represents the only chance of cure in several pts with pancreatic disease we think that it should be offered also to elderly pts.
- Di Benedetto F, et al: Pancreatic Resections for Malignancy in patients aged 70 and older. Journal of the American Geriatrics Society. 2009, 57 (7): 1323-1324. 10.1111/j.1532-5415.2009.02332.x.PubMedView ArticleGoogle Scholar
- Ballarin R, et al: Do not deny pancreatic resection to elderly patients. J Gastrointest Surg. 2009, 13 (2): 341-348. 10.1007/s11605-008-0601-0.PubMedView ArticleGoogle Scholar
- Hwang Sang, et al: Surgical palliation of unresectable pancreatic head cancer in elderly patients. World J Gastroenterol. 2009, 15 (8): 978-982. 10.3748/wjg.15.978.PubMedPubMed CentralView ArticleGoogle Scholar
- Hanada K: Current treatment strategies for pancreatic cancer in the elderly. Drugs Aging. 2006, 23 (5): 403-410. 10.2165/00002512-200623050-00004.PubMedView ArticleGoogle Scholar
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