title: Perioperative and long-term outcomes after pancreaticoduodenectomy in elderly patients 80 years of age and older.
abstract: OBJECTIVE
  Although a pancreaticoduodenectomy (PD) has been recently regarded as a safe surgical procedure at high-volume centers, the efficacy of PD for patients 80 years of age and older is controversial. The aim of this study was to evaluate the perioperative and long-term outcomes following PD in patients 80 years of age and older.
  
  
  METHODS
  Elderly patients 80 years of age and older who underwent PD between 2001 and 2009 were identified. The perioperative and long-term outcomes were compared with patients younger than 80 years of age.
  
  
  RESULTS
  Of 561 total patients, 22 patients (3.9 %) were 80 years of age or older. Mortality occurred in one patient (4.5 %). Postoperative major complications (Clavien-Dindo classification ≥ grade III) occurred in six patients (27.3 %) in this group, which was significantly higher than in patients younger than 80 years of age (P = 0.008). The survival of the elderly patients undergoing PD for pancreatic cancer was significantly shorter than that for the same patient group with other diseases (median survival, 13 versus 82 months; P = 0.014). Only one elderly patient with pancreatic cancer survived more than 3 years.
  
  
  CONCLUSIONS
  PD for pancreatic cancer in patients aged 80 and older should be carefully selected, because it is associated with a higher incidence of severe postoperative complications and a small change of long-term survival.
authors: Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, 5-1-1Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
authors: Seiji
authors: S
authors: Oguro
authors: Kazuaki
authors: K
authors: Shimada
authors: Yoji
authors: Y
authors: Kishi
authors: Satoshi
authors: S
authors: Nara
authors: Minoru
authors: M
authors: Esaki
authors: Tomoo
authors: T
authors: Kosuge
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery*; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000601:surgery*; D002173:Cancer Care Facilities; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000601:surgery*; D005500:Follow-Up Studies; D005706:Gallbladder Neoplasms / Q000401:mortality / Q000601:surgery*; D006305:Health Status Indicators; D061847:Hospitals, High-Volume; D006801:Humans; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000401:mortality; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult