title: Pancreaticoduodenectomy can be safely performed in the elderly.
abstract: BACKGROUND
  Although pancreaticoduodenectomy has been recognized in the past for its severe complications, improvements in operative methods and perioperative management have made it a safe procedure. Therefore, pancreaticoduodenectomy can be performed in elderly patients, and our experience and outcomes are described in this report.
  
  
  METHODS
  We retrospectively investigated 142 patients in whom pancreaticoduodenectomy was performed without stenting tubes during pancreaticojejunostomy. The patients were classified into two groups: (A) those older and (B) younger than 75 years. The outcomes, including preoperative characteristics, intraoperative characteristics, postoperative complications and mortality, are herein reported. Continuous variables were compared using Student's t test and the Chi-square test.
  
  
  RESULTS
  There were no differences between groups A and B in terms of sex, operative time, amount of blood loss, performance status, soft pancreas rate, disease distribution and operative procedure. Comorbidities in groups A and B were statistically different. Regarding the preoperative status, the elderly patients exhibited lower serum albumin and hemoglobin levels than the younger patients. There were no differences in mortality (0 vs. 0 %), morbidity (24.3 vs. 29.5 %, p = 0.362), postoperative hospital days or major complications such as pancreatic fistula development, delayed gastric emptying, intra-abdominal abscess development, biliary fistula formation and postpancreatectomy hemorrhage.
  
  
  CONCLUSIONS
  Pancreaticoduodenectomy can be safely performed in elderly as well as younger patients.
authors.affiliation: Department of Surgery, Hachioji Digestive Disease Hospital, 177-3 Yorozu-cho, Hachioji, Tokyo 192-0903, Japan. dr802@nifty.com
authors.forename: Shuji
authors.initials: S
authors.lastname: Suzuki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kaji
authors.forename: Nobusada
authors.initials: N
authors.lastname: Koike
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Harada
authors.forename: Mamoru
authors.initials: M
authors.lastname: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000517:prevention & control; D010190:Pancreatic Neoplasms / Q000601:surgery; D010193:Pancreaticojejunostomy / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome; D055815:Young Adult