Outcomes of Pancreatic Resections in the Elderly and Geriatric Patients

Česká verzia

Authors: R. Svatoň; M. Man; Z. Kala; V. Procházka ; J. Hlavsa; I. Penka
Authors place of work: Chirurgická klinika Lékařské fakulty Masarykovy univerzity a Fakultní nemocnice Brno-Bohunice přednosta: prof. MUDr. Zdeněk Kala, CSc.
Published in the journal: Rozhl. Chir., 2008, roč. 87, č. 10, s. 521-526.
Category: Monothematic special - Original

Summary

As a result of the population aging, we are confronted with the problematics of geriatric patients more and more frequently. The aim of this retrospective study was to compare outcomes of pancreatic resections in patients of three different age groups.

During 2000–2007, 150 pancreatic resections were performed in our clinic, including 34 (22.7%) patients aged 65 and over at the time of the procedure and 5 (3.3%) patients over 75 y.o.a. The procedures were heterogenous, including indications for oncologic diagnoses, as well as for chronic pancreatitis.

Our assessment demonstrated no significant differences in the 30-day postoperative mortality between the group of subjects over 65 y.o.a, geriatric group (i.e. over 75 y.o.a) and the group of subjects below 54 y.o.a. (8.8% vs. 0% vs. 5.2%). Furthermore, the postoperative morbidity showed no statistically significant differences between the all three groups (30.2% vs. 29.4% vs. 20%). The commonest postoperative complications included secondary healing of the surgical wound (7.8%) and pancreatic fistules (6.9%) in the group of subjects below 65 y.o.a., and insufficiency of the pancreatic-jejunal anastomosis (5.8%) and hepatic- jejunal anastomosis (5.88%) in the group aged 65 and over.Pancreatic-jejunal anastomosis insufficiency, complicated by consecutive bleeding, contributed to postoperative mortality most significantly. Significant increase in postoperative complication rates connected to proximal pancreatoduodenectomies and total pancreatoduodenectomies, was recorded in patients over 65, compared to those in the young patient group (p = 0.014). No statistically significant relation was found between a particular comorbidity and onset of postoperative complications or deaths in patients over 65 or geriatric patients.

Based on the results, the authors do not consider the patient’s age a contraindication for pancreatic resection procedures. Radical resections can be performed with acceptable mortality and morbidity rates in geriatric patients.

Key words:
resection – pancreas – geriatric patient

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