Perioperative Outcomes after Pancreaticoduodenectomy in Elderly Patients

Pancreaticoduodenectomy (PD) is highly invasive and may be associated with critical to fatal complications. The purpose of this study is to demonstrate, using multivariate analysis of preoperative and intraoperative patient characteristics to determine risk factors for negative outcomes, that PD can be performed safely in the elderly.

We enrolled 108 patients who underwent PD between October 2007 and December 2014. We compared perioperative outcomes such as the incidence of post-operative complications, duration of hospital stay, and mortality between elderly (group A; age ≥ 75 years, n = 44) and younger (group B; age < 75 years, n = 64) groups.

Death occurred in one patient (2.3%) in group A. There were no significant differences between the groups in rates of major complications, including pancreatic fistula (PF), delayed gastric emptying, intra-abdominal bleeding, pneumonia, or duration of hospital stay. Multivariate analysis revealed complications in elderly to be associated with hemoglobin concentration (P = 0.016), and PF to be associated with body mass index (P = 0.013) and soft pancreas (P = 0.005).

PD can be performed safely in elderly patients aged ≥ 75 years. However, PD indication for elderly having low hemoglobin concentration patients should be carefully selected.