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Radical surgical treatment of duodeno-pancreatic neoplasms in elderly patients: our experience

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Aim of the study

To evaluate the results of surgical treatment of duodeno-pancreatic neoplasms in elderly patients, in terms of mortality, morbidity and survival.

Materials and methods

From 01/01/1994 to 01/10/2008 48 patients aged more than 65 years old, 29 males (60.42%), 19 females (39.58%) mean age 67 years old (range 65–81), underwent radical surgery for duodeno-pancreatic neoplasms.

24 patients (50.00%) were affected by pancreatic head carcinoma, 5 (10.42%) by distal common bile duct cancer, 11 (22.92%) by ampullary cancer, 4 (8.32%) by duodenal carcinoma, 1 (2.08%) by infiltrating right colon carcinoma, 2 (4.16%) by distal pancreatic cancer, 1 by focal pancreatitis.

Results

44 patients (91.67%) underwent pancreaticoduodenectomy (37 standard, 7 extended, with Wirsung gastric anastomosis in 19 cases, Wirsung-jejunal anastomosis in 34, and Wirsung closure in 1); 3 patients (6.25%) underwent total pancreaticoduodenectomy, 1 patient distal pancreatectomy. 2 patients were also treated with IORT. Perioperative mortality was 4.16%, morbidity was 10.42% (2 cases of peritoneal bleeding, 3 gastrointestinal bleeding, 2 portal thrombosis, 1 pancreatic fistula). 3 years survivorship was 22% (N0:18%, N1:2%); 5 years survivorship was 16% (N0:14%, N1:2%). Causes of death were liver metastasis (29.17%), local recurrence (10.42%), cardiovascular and cerebrovascular events (4.16%).

Conclusion

Radical surgery for duodeno-pancreatic tumors could be a good option in elderly patients; despite comorbidities, in our experience we observed good results in terms of survival and morbidity, similar to what observed in younger patients.

Author information

Correspondence to A Oldani.

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Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Keywords

  • Pancreatitis
  • Pancreatic Cancer
  • Common Bile Duct
  • Pancreatic Fistula
  • Distal Pancreatectomy