title: Should pancreaticoduodenectomy be performed in the elderly?
abstract: OBJECTIVE
  Pancreaticoduodenectomy (PD) is indicated in benign or malignant pancreatic head diseases. It is a difficult operation with high morbidity especially in elderly patients. The aim of our study was to determine whether pancreaticoduodenectomy is associated with higher morbidity and mortality in patients ≥ 70 years old.
  
  
  METHODS
  During 17 years, 173 patients were operated by Whipple intervention, whatever the disease. From a prospective database, patients were divided in 2 groups (Group A ≥ 70 years old, Group B <70).
  
  
  RESULTS
  Postoperative mortality was not significantly higher in elderly (12% vs. 4.1%; p=0.06). However, re-intervention and morbidity were more important in univariate analysis (p=0.03 and p=0.002 respectively). In multivariate analysis, age ≥ 70 years old was not an independent prognostic factor of mortality (p=0.27) and re-intervention (p=0.07). Whereas age (p=0.04) and preoperative morbidity (p=0.02) were independent prognostic factors of morbidity.
  
  
  CONCLUSIONS
  PD requires careful patient selection. However, age should not be a limiting factor.
authors.affiliation: Visceral Department, CHU Angers, France.
authors.forename: Dorothée
authors.initials: D
authors.lastname: Brachet
authors.forename: Emilie
authors.initials: E
authors.lastname: Lermite
authors.forename: Karina
authors.initials: K
authors.lastname: Vychnevskaia-Bressollette
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Mucci
authors.forename: Antoine
authors.initials: A
authors.lastname: Hamy
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Arnaud
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D005260:Female; D005602:France; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010182:Pancreatic Diseases / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome