title: The impact of old age on surgical outcomes after pancreaticoduodenectomy for distal bile duct cancer.
abstract: OBJECTIVE
  To compare surgical results and survival of two groups of patients, age ≥70 vs. age <70, who underwent pancreaticoduodenectomy and to identify the safety of this procedure for elderly patients for the treatment of distal common bile duct (CBD) cancer.
  
  
  METHODS
  Between January 2003 and December 2009, 55 patients who underwent pancreaticoduodenectomy for the treatment of distal CBD cancer at Keimyung University Dong San Medical Center were enrolled in our study.
  
  
  RESULTS
  Of 55 patients, 28 were male and 27 female. Nineteen were over 70 years old (older group) and 36 were below 70 years (younger group). The mean ages of the two groups of patients were 73.5 years and 60.5 years respectively. Although patients of the older group had significantly more comorbid diseases, perioperative results including operation time, amount of intraoperative bleeding, duration of postoperative hospital stay and postoperative complications were not significantly different. A higher level (more than 5 mg/dl) of preoperative initial bilirubin showed significant correlations with operative morbidity by univariate analysis, and age was not an independent risk factor of operative morbidity. Overall 5 year survival of older and younger groups were 45.9% and 39.5% respectively (p=0.671) and disease-free 5-year survival were 31.7% and 31.1%, respectively (p=0.942).
  
  
  CONCLUSIONS
  Surgical outcomes of elderly patients were similar to those of younger patients, despite a higher incidence of comorbid disease. This results shows that pancreaticoduodenectomy can be applied safely to elderly patients.
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Je-Wook
authors.initials: JW
authors.lastname: Shin
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Keun Soo
authors.initials: KS
authors.lastname: Ahn
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Koo Jeong
authors.initials: KJ
authors.lastname: Kang
authors.affiliation: Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Lim
keywords: Bile duct neoplasm; Old age; Pancreaticoduodenectomy