title: Surgical outcomes of pancreaticoduodenectomy for periampullary tumors in elderly patients.
abstract: BACKGROUND
  Pancreaticoduodenectomy (PD) is an aggressive surgery with considerable operative risks, but offers the only chance for cure in patients with periampullary tumors. A growing number of elderly patients are being offered PD because of the aging of populations in developed countries. We examined surgical outcomes of PD in patients aged 75 years and older (≥75 years).
  
  
  METHODS
  A retrospective cohort study was performed in 65 consecutive patients who underwent PD for periampullary tumors at a single medical center during the 5 years from 2006 to 2010. We analyzed surgical outcomes such as mortality and morbidity after PD in patients aged ≥75 years (n = 21) compared to those in patients aged <75 years (n = 44).
  
  
  RESULTS
  The positive rate of comorbidities such as hypertension was significantly higher in patients aged ≥75 years than in patients aged <75 years (76 vs. 48 %; p = 0.03). The incidence of wound infection was significantly higher in patients aged ≥75 years than in patients aged <75 years (19 vs. 0 %; p < 0.01). However, there was no significant difference in the mortality rate (0 vs. 2 %; p = 0.49) or the overall morbidity rate (33 vs. 32 %; p = 0.90). There was no significant difference in changes in body weight or serum albumin levels during the 3 months after PD between the two groups, but the recovery of serum prealbumin levels from 1 to 3 months after PD in patients aged ≥75 years was significantly delayed compared to that in patients aged <75 years (p = 0.04). There was no statistically significant difference in long-term survival between the two groups.
  
  
  CONCLUSIONS
  Advanced age alone should not discourage surgeons from offering PD, although nutritional supports after PD for elderly patients aged ≥75 years are needed.
authors: Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, 1-9-6 Senda-machi, Naka-ku, Hiroshima 730-8619, Japan. yamashi@surg2.med.kyushu-u.ac.jp
authors: Yo-Ichi
authors: Y
authors: Yamashita
authors: Ken
authors: K
authors: Shirabe
authors: Eiji
authors: E
authors: Tsujita
authors: Kazuki
authors: K
authors: Takeishi
authors: Tetsuo
authors: T
authors: Ikeda
authors: Tomoharu
authors: T
authors: Yoshizumi
authors: Yoshinari
authors: Y
authors: Furukawa
authors: Teruyoshi
authors: T
authors: Ishida
authors: Yoshihiko
authors: Y
authors: Maehara
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery*; D001835:Body Weight; D015331:Cohort Studies; D003138:Common Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D016577:Pancreaticoduodenectomy / Q000401:mortality; D011183:Postoperative Complications / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D011228:Prealbumin / Q000378:metabolism; D012189:Retrospective Studies; D012306:Risk; D012709:Serum Albumin / Q000378:metabolism; D013530:Surgical Wound Infection / Q000097:blood / Q000175:diagnosis / Q000401:mortality; D016896:Treatment Outcome
chemical_list: D011228:Prealbumin; D012709:Serum Albumin