Safe major abdominal operations: hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients.
OBJECTIVE
To evaluate the impact of advanced age on outcome after hepatectomy, gastrectomy and pancreatoduodenectomy.


METHODS
Two hundreds and eleven patients undergone hepatectomy, gastrectomy and pancreatoduodenectomy from January 1998 to September 2002 were analyzed retrospectively. Clinicopathologic features and operative outcome of 83 patients aged 65 years or more were compared with that in 128 younger patients aged less than 65 years.


RESULTS
The nutritional state, such as pre-operation level of serum albumin and hemoglobin in the older patients was poorer than that in the younger patients. The older patients had higher comorbidities than the younger patients (48.2% vs 15.6%). No significant difference was observed in perioperative mortality, and complication rate between the older and younger patients (2.4% vs 1.6% and 22.9% vs 20.3%, respectively). Multivariate analysis demonstrated that pancreatoduodenectomy, hepatectomy with resection of more than 2 segments and comorbidities were independent predictors of postoperative complication, whereas age was not (P=0.3172).


CONCLUSIONS
It is safe for patients aged 65 years or more to undergo hepatic, pancreatic and gastric resection if great care is taken during perioperative period.
Wu
Yu-Lian
YL
Department of Surgery, 2nd Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China. wuyulian@medmail.com.cn
Yu
Jun-Xiu
JX
Xu
Bin
B
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015897:Comorbidity; D005260:Female; D005743:Gastrectomy / Q000401:mortality*; D006454:Hemoglobins; D006498:Hepatectomy / Q000401:mortality*; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000401:mortality*; D012189:Retrospective Studies; D012709:Serum Albumin; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*
D006454:Hemoglobins; D012709:Serum Albumin