Pancreatic Surgery for Cystic Lesions in Elderly Patients: Is Age a Relevant Risk Factor for Postoperative...

Background The increasing use of high-resolution imaging techniques in an aging society leads to an increased number of cystic pancreatic lesion diagnoses. In this study, we compared two patient groups who underwent surgery for a benign pancreatic cystic lesion, investigating whether a difference in postoperative outcomes can be observed based on patient age. Methods The single-center retrospective analysis included 54 patients who underwent surgery for a benign pancreatic cystic lesion between 2015 and 2024. Two groups were formed. Group I included 26 patients who were 70 years or younger at the time of surgery, and Group II consisted of 28 patients who were older than 70 years. The primary endpoint was 90-day mortality. Secondary endpoints were the risk of postoperative pancreatic fistulas, the revision rate, surgical site infection, delayed gastric emptying, ventilation time longer than 48 hours, need for postoperative transfusion, and the occurrence of postoperative pneumonia. Results A higher 90-day mortality was observed in the older patient group (14.3% versus 7.7%, p = 0.562). A clinically relevant difference was found in the risk of postoperative pancreatic fistulas (30.8% versus 3.6%, p = 0.028). The other secondary endpoints pneumonia risk (7.7% versus 10.7%, p = 0.254), pancreatic anastomosis insufficiency risk (11.1% versus 12.5%, p = 0.244), surgical site infection risk (7.7% versus 3.6%, p = 0.738), delayed gastric emptying (15.4% versus 14.3%, p = 0.998), postoperative ventilation time over 48 hours (11.5% versus 14.3%, p = 0.520), revision rate (23.1% versus 17.9%, p = 0.666), postoperative bleeding requiring transfusion (15.4% versus 7.1%, p = 0.814) and postoperative length of stay (17.3 days versus 17.4 days, p = 0.441) did not differ relevantly between the groups. Conclusion Based on our study, there were statistically significant differences in the risk of postoperative pancreatic fistulas and higher mortality in the older patient group. Based on the retrospective nature, definitive claims can not be made.