title: A pancreaticoduodenectomy is acceptable for periampullary tumors in the elderly, even in patients over 80 years of age.
abstract: BACKGROUND
  Although the mortality rates for pancreaticoduodenectomy have been reported to be low for periampullary tumors at high-volume centers, postoperative results still remain unclear for elderly patients over 80 years of age.
  
  
  METHODS
  This was a retrospective study of patients who underwent a pancreaticoduodenectomy and consisted of 335 patients who were treated for periampullary tumors between January 1994 and August 2008. The main outcomes were postoperative complications, mortality, and the length of hospital stay among the elderly patients, and they were analyzed in three groups: elderly patients over 80 years old, septuagenarians, and those under 70 years of age.
  
  
  RESULTS
  The performance status of elderly patients was lower than that of the patients under 70 (P < 0.05), and the elderly had a higher American Society of Anesthesiologists physical status classification score (P < 0.001) as well as low hemoglobin and serum albumin levels (P < 0.01 and P < 0.001, respectively). The incidence of delayed gastric emptying in the elderly was higher; however, there was no significant difference. The other outcomes in the elderly group were similar to those of the other groups.
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy was considered to be a feasible surgical procedure for elderly patients who had a good performance status.
authors.affiliation: Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama, 641-8510, Japan.
authors.forename: Masaji
authors.initials: M
authors.lastname: Tani
authors.forename: Manabu
authors.initials: M
authors.lastname: Kawai
authors.forename: Seiko
authors.initials: S
authors.lastname: Hirono
authors.forename: Shinomi
authors.initials: S
authors.lastname: Ina
authors.forename: Motoki
authors.initials: M
authors.lastname: Miyazawa
authors.forename: Ryohei
authors.initials: R
authors.lastname: Nishioka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shimizu
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Uchiyama
authors.forename: Hiroki
authors.initials: H
authors.lastname: Yamaue
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000473:pathology* / Q000601:surgery; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D007902:Length of Stay; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome