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Efficacy of modified Appleby surgery: a benefit for elderly patients?
Xinjing Wang1, Yang Dong1, Jiabin Jin1
1Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
Background:
To explore the feasibility, safety, and indications of the modified Appleby operation for carcinoma of the body and tail of the pancreas and to identify prognostic factors.
Material And Methods:
Data from a total of 15 patients receiving the modified Appleby operation in our department were retrospectively analyzed. Correlation analyses and univariate and multivariate analyses of the survival time were performed to identify prognostic factors.
Results:
The operations were successful in all 15 patients. The median survival time was 19 mo except in one case, where the patient died; and the 1- and 3-y survival rates were 86.7% (13/15) and 6.7% (1/15), respectively. A positive correlation was found between age and survival time (P = 0.037, Pearson correlation = 0.541). In addition, univariate analysis, age, operative time, and perineural invasion were correlated with survival time (P = 0.029, 0.035, and 0.049, respectively). Finally, multivariate analysis revealed that only age ≥ 60 y was correlated with survival (Hazard ratio = 0.263, P = 0.044).
Conclusions:
The improved Appleby operation was feasible and safe when performed in experienced centers by experienced surgeons and can improve the patients' survival time and quality of life. Statistical analysis suggests that elderly patients may have a better prognosis than younger patients to some extent.
