Advanced age does not increase morbidity in pancreaticoduodenectomy

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Geriatric Surgery

Background:

• Increasing life expectancy leads to more elderly patients undergoing complex surgeries like pancreaticoduodenectomy (PD).
• Evaluating the safety and risk factors for severe complications of PD in patients over 75 is crucial.

Purpose of the Study:

• To assess the safety of pancreaticoduodenectomy (PD) in patients aged 75 and older.
• To identify risk factors associated with severe postoperative complications in this elderly cohort.

Main Methods:

• Retrospective review of patients who underwent PD for periampullary tumors.
• Patients were divided into two groups: <75 years (Group A) and >75 years (Group B).
• Primary endpoint was severe complications (Clavien grade ≥3); secondary endpoints included mortality and any complications.

Main Results:

• No significant difference in severe complications (17% vs. 10%, P=0.72) or overall complications (50% vs. 50%, P>0.999) between groups.
• While mortality was higher in the younger group (8.6% vs. 0%), it was not statistically significant (P=0.333).
• Multivariate analysis identified male sex, obesity, and American Society of Anesthesiology Score 3-4 as predictors of severe complications.

Conclusions:

• Age over 75 is not a contraindication for pancreaticoduodenectomy (PD).
• Poor clinical status, obesity, and male gender are associated with severe complications.
• PD can be considered a safe procedure for elderly patients when indicated.