Pancreatic resections: 30 and 90-day outcomes in octogenarians

Area of Science:

• Surgical Oncology
• Geriatric Surgery
• Gastrointestinal Oncology

Background:

• Pancreatic tumors are prevalent in older adults, with a median diagnosis age of 70.
• Increased imaging detection of pancreas masses leads to more surgeries in elderly patients.
• Pancreatic surgeons frequently encounter octogenarians requiring operative intervention.

Purpose of the Study:

• To evaluate the safety and outcomes of pancreatic resection in octogenarians.
• To compare surgical outcomes between patients aged 80+ and those younger than 80.
• To assess the impact of a dedicated surgical oncology team on octogenarian pancreatic surgery outcomes.

Main Methods:

• Retrospective chart review of pancreatic resections over 13 years.
• Comparison of patient characteristics and operative outcomes between octogenarians and younger patients.
• Univariate analyses using Student t-tests, Fisher's exact test, and Kruskal-Wallis tests.

Main Results:

• 48 of 403 pancreatic resections were in patients aged 80+.
• No significant differences in procedure complexity, operative times, or blood loss between age groups.
• Similar rates of complications (e.g., delayed gastric emptying, pancreatic leak), 30-day reoperation, readmission, and mortality.
• Octogenarians had higher 90-day readmission rates after Whipple without increased major complications.

Conclusions:

• Highly selected octogenarians can safely undergo pancreatic resection.
• Outcomes in octogenarians are comparable to younger patients at high-volume centers with specialized teams.
• Pancreatic resection is a viable option for carefully chosen elderly patients.