title: Pancreatic resection in patients 80 years or older: a meta-analysis and systematic review.
abstract: OBJECTIVE
  The aim of this study was to evaluate the safety of pancreatic resections in patients 80 years or older.
  
  
  METHODS
  A systematic search of the literature was carried out that compared perioperative outcomes after pancreatic resection in patients 80 years or older with patients younger than 80 years. The primary end points were postoperative mortality and morbidity. The secondary end points were incidence of postoperative pancreatic fistula, delayed gastric emptying, bile leak, pneumonia, postoperative infection, cardiologic complications, reoperation, and length of hospital stay.
  
  
  RESULTS
  Nine studies were found to be suitable for the meta-analysis. The postoperative mortality and morbidity were significantly higher in the group 80 years or older (P < 0.00001 and P = 0.003, respectively) except for patients in whom there were no differences in preoperative comorbidities (P = 0.56 and P = 0.36, respectively). Postoperative cardiac complications were significantly more frequent in patients 80 years or older (P < 0.0001), and the length of hospital stay was significantly longer in octogenarian patients (P = 0.008).
  
  
  CONCLUSIONS
  Patients 80 years or older have an increased incidence of postoperative mortality, morbidity, and cardiac complications and a longer length of hospital stay than do younger patients. Thus, pancreatic resection can be recommended only in a selected group of patients 80 years or older.
authors.affiliation: From the Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casadei
authors.forename: Claudio
authors.initials: C
authors.lastname: Ricci
authors.forename: Enrico
authors.initials: E
authors.lastname: Lazzarini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Taffurelli
authors.forename: Marielda
authors.initials: M
authors.lastname: D'Ambra
authors.forename: Marianna
authors.initials: M
authors.lastname: Mastroroberto
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Morselli-Labate
authors.forename: Francesco
authors.initials: F
authors.lastname: Minni
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D000369:Aged, 80 and over; D003138:Common Bile Duct Neoplasms / Q000601:surgery; D015897:Comorbidity; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010180:Pancreatectomy / Q000401:mortality / Q000706:statistics & numerical data*; D010190:Pancreatic Neoplasms / Q000453:epidemiology / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000401:mortality / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation / Q000706:statistics & numerical data; D016896:Treatment Outcome