title: Surgical palliation of unresectable pancreatic head cancer in elderly patients.
abstract: OBJECTIVE
  To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer.
  
  
  METHODS
  Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (Group A). These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass (Group B). In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older (Group C), who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life.
  
  
  RESULTS
  Five patients (26.0%) in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death (5.3%) occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree (P = 0.019, P = 0.029, respectively). The median hospital-free survival period and the median overall survival were also significantly longer in Group A (P = 0.001 and P < 0.001, respectively).
  
  
  CONCLUSIONS
  Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head cancer.
authors.affiliation: Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Jongno-Ku, Seoul, South Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Hwang
authors.forename: Hyung Ook
authors.initials: HO
authors.lastname: Kim
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Chang Hak
authors.initials: CH
authors.lastname: Yoo
authors.forename: Hungdai
authors.initials: H
authors.lastname: Kim
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Shin
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery / Q000628:therapy*; D000368:Aged; D015904:Biliopancreatic Diversion; D001663:Bilirubin / Q000097:blood; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy*; D011788:Quality of Life; D012189:Retrospective Studies; D016019:Survival Analysis; D017741:Survivors
chemical_list: D001663:Bilirubin