title: Description of pylorus-preserving pancreaticoduodenectomy in elderly patients.
abstract: OBJECTIVE
  The aim of this paper is to examine the safety and feasibility of pylorus-preserving pancreaticoduodenectomy in elderly patients.
  
  
  METHODS
  The study population consisted of 40 consecutive patients. They were divided into two groups: Group A (<75 years old) and Group B (=75 years old). Reconstruction with a vertical duodenojejunostomy and internal pancreatic drainage with an omental wrapping was performed on the patients in both the groups.
  
  
  RESULTS
  Less time was required to complete the operations in Group B (280±20min) than in Group A (386±88min; p=0.0006). Intraoperative blood loss in Group B was significantly lesser (365±109g) than that in Group A (629±249g; p=0.0026). No statistically significant difference was observed between both groups, in terms of the length of time required until food intake resumed and length of hospital stay. Although the rate of postoperative complication was higher in Group B (10.0%), no statistically significant difference was observed.
  
  
  CONCLUSIONS
  Pylorus-preserving pancreaticoduodenectomy with a vertical duodenojejunostomy and internal pancreatic drainage with an omental wrapping seems safe and can be performed on elderly patients without a significant risk of complications.
authors.affiliation: Department of General Surgical Science, Gunma University Graduate School of Medicine, Japan. tatsuoshimura@gmail.com
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Shimura
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Morinaga
authors.forename: Hideki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Araki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Koyama
authors.forename: Rei
authors.initials: R
authors.lastname: Yashima
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibata
authors.forename: Seiichi
authors.initials: S
authors.lastname: Takenoshita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D016009:Chi-Square Distribution; D004322:Drainage; D004385:Duodenostomy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007564:Japan; D007582:Jejunostomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery; D059351:Organ Sparing Treatments / Q000009:adverse effects; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D018579:Patient Selection; D011708:Pylorus; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome