Su2054 AGE IS ONLY A NUMBER - BUT WHAT IS THE RIGHT NUMBER FOR A WHIPPLE PROCEDURE?

Background: Pancreatic cancer is a dismal systemic malignancy with stagnant cure rate.Fortunately, patient selection has become increasingly objective and operative mortality has declined to less than 5%.There continues to be reasonable and insightful discussion regarding the utility of pancreaticoduodenectomy (PD) in the elderly.Given the established morbidity and mortality rates of PD, many have argued against the significant risks of PD in this population given the admitted relative short term survival benefit.We hypothesized that elderly individuals if appropriately selected would benefit from PD. Methods: Review of all PD performed by a large health care system Hepato-Pancreatico-Biliary (HPB) team from 2012-2018.All individuals undergoing PD and their outcomes were accounted for in our systems electronic medical record.Primary outcome measures were length of stay (LOS) and 90-and 365-day mortality in elderly (>80 years of age) versus younger (<80 years of age) individuals.Results: 887 individuals underwent PD within the NCAL HPB surgical service from 2012-2018.Seventy-five (8.5%) of these individuals were 80 years or older and their diagnosis (cancer) and operative time (shorter) were significant as was their total ICU days (longer) post-operatively (p > 0.05).However, the elderly individuals had no significant difference in post-operative LOS or 90-and/or 365-day mortality (p < 0.05). Conclusion:Elderly patients if appropriately selected are appropriate candidates for PD.As anticipated, the elderly individuals underwent PD predominantly due to malignant etiology.The more expeditious operative time in the elderly likely reflects a selection bias.However, the lack of significant difference in LOS and 90-and/or 365-day mortality suggest that elderly individuals do indeed gain valuable and durable time with operative intervention.