title: Efficacy of modified Appleby surgery: a benefit for elderly patients?
abstract: BACKGROUND
  To explore the feasibility, safety, and indications of the modified Appleby operation for carcinoma of the body and tail of the pancreas and to identify prognostic factors.
  
  
  METHODS
  Data from a total of 15 patients receiving the modified Appleby operation in our department were retrospectively analyzed. Correlation analyses and univariate and multivariate analyses of the survival time were performed to identify prognostic factors.
  
  
  RESULTS
  The operations were successful in all 15 patients. The median survival time was 19 mo except in one case, where the patient died; and the 1- and 3-y survival rates were 86.7% (13/15) and 6.7% (1/15), respectively. A positive correlation was found between age and survival time (P = 0.037, Pearson correlation = 0.541). In addition, univariate analysis, age, operative time, and perineural invasion were correlated with survival time (P = 0.029, 0.035, and 0.049, respectively). Finally, multivariate analysis revealed that only age ≥ 60 y was correlated with survival (Hazard ratio = 0.263, P = 0.044).
  
  
  CONCLUSIONS
  The improved Appleby operation was feasible and safe when performed in experienced centers by experienced surgeons and can improve the patients' survival time and quality of life. Statistical analysis suggests that elderly patients may have a better prognosis than younger patients to some extent.
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Xinjing
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Jiabin
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhan
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Baiyong
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China. Electronic address: dxx888888@gmail.com.
authors.forename: Xiaxing
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Chenghong
authors.initials: C
authors.lastname: Peng
authors.affiliation: Department of General Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Appleby; Celiac axis resection; Pancreatic tumor; Surgical operation