Safety and efficacy of Pancreaticoduodenectomy for malignancy in octogenarians

Introduction: Management of malignancy in the elderly has become a global clinical issue, considering the increase of life expectancy in many countries. The aim of this study was investigated the safety and efficacy of pancreaticoduodenectomy (PD)in patients aged 80 years or more compared with younger patients. Method: A retrospective analysis was conducted for 97 consecutive patients who underwent a PD. Of these 97 patients, fifteen patients aged 80 years of more at the time of surgery were assigned to the Octogenarian group, and the other younger 82 patients were assigned to the Younger group. Postoperative morbidities were graded according to the Clavien-Dindo classification. In the present study, we defined any postoperative major complication worse than grade II as a complication.The backgrounds, operative results and morbidity were compared between two groups. Result: No in-hospital death occurred in this study. The median operative time and intraoperative blood loss were 600 minutes and 651ml in the Octogenarian group, 614 minutes and 688ml in the Younger group, respectively. There was no significant difference between the two groups. Major complications occurred in 14 patients (20%; 3 in the Octogenarian groupand 13%; 11 in the Younger group), and the incidence of complication did not differ between the two groups. In other parameters, including the incidence of postoperative pancreatic fistula and hospital stay, there was no significant difference between the two groups. Conclusion: Based on our clinical experience, we conclude that pancreaticoduodenectomyis safe and effective, even in octogenarians.