Pancreatic resection for periampullary cancer in elderly patients

Major abdominal surgery in elderly patients has traditionally been thought to carry a high operative risk. Recent data, however, have suggested that with proper selection, elderly patients can withstand pancreatic resection.

The medical records of 102 patients who underwent pancreatic resection for pancreatic or periampullary tumors were retrospectively reviewed. Twenty-nine patients were aged 70 years or older (mean age: 74 years) and 73 patients were younger (mean age: 56 years). Concomitant comorbid conditions were evaluated in the patients of both groups, and no significant differences were identified. A pancreaticoduodenectomy was performed in 81 cases and a total pancreatectomy in 21.

The operative mortality rate was 0% in the older patients and 6.8% in the younger patients. Major complications occurred in 28% of the patients. There were no significant differences in morbidity among the two age groups. The overall actuarial survival curves showed similar trends in both groups.

With appropriate preoperative selection, pancreatic resection can be performed with low operative risk in elderly patients. Chronological age alone should not be considered an absolute contraindication for pancreatic resection.