title: Comparison of postoperative morbidity in elderly patients who underwent pancreatic resection.
abstract: OBJECTIVE
  Operative indications for pancreatectomy in elderly patients with pancreatic disease remain controversial. We examined clinicopathological characteristics and early outcomes in each generation of 147 patients who underwent pancreatectomy.
  
  
  METHODS
  Patients were divided into four groups: Group 1 (n=15, 10%), young patients <50 years old; Group 2 (n=65; 44%), patients at 50- 69 years old; Group 3 (n=61, 42%), patients at 70-79 years old and Group 4 (n=6, 4%), elderly patients >80 years old. Clinicopathological and surgical parameters were examined, including estimation of physiological ability and surgical stress consisting of preoperative risk score (PRS), surgical stress score (SSS) and comprehensive risk score (CRS).
  
  
  RESULTS
  Prevalence of co-morbidity and American Society of Anesthesiologists (ASA) score increased significantly with increasing patient age (p<0.05). Extent of pancreatectomy and lymphadenectomy did not differ between groups and surgical records were similar. Tumor stage, postoperative course and complications were similar between groups. PRS and CRS increased significantly with increasing patient age (p<0.05) but SSS did not. Univariate analysis identified presence of systemic comorbidity, ASA score =2 and PRS =0.32 as factors associated with postoperative complications, but no independent predictive parameters were identified on multivariate analysis.
  
  
  CONCLUSIONS
  Careful management and adequate decisions regarding pancreatectomy upon identification of co-morbidity, ASA score and PRS are important in elderly patients with pancreatic disease before pancreatectomy.
authors.affiliation: Department of Surgery, Nagasaki University Hospital, Nagasaki, Japan. a-nanasm@nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Tomohito
authors.initials: T
authors.lastname: Morisaki
authors.forename: Ryohei
authors.initials: R
authors.lastname: Uehara
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009367:Neoplasm Staging; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies