title: Is age a barrier to pancreaticoduodenectomy? An Italian dual-institution study.
abstract: The aim of this study is to evaluate the role of age after pancreaticoduodenectomy. This is a retrospective study of 223 patients who underwent pancreaticoduodenectomy for periampullary diseases. Three age groups of patients were compared: ≤70 years of age (group A); between 71 and 79 years of age (group B) and 80 years of age or older (group C). The primary endpoint was the postoperative mortality rate. Secondary endpoints were the overall postoperative morbidity, postoperative pancreatic fistula, postoperative pancreatic haemorrhage, bile leakage, delayed gastric emptying rates, the length of hospital stay, intensive care unit stay, the type of discharge from hospital, reoperation rate and overall survival. Uni-multivariate analyses and Kaplan-Meier curve were carried out. At univariate analysis, only the type of discharge from hospital showed that group B and C patients required a period of rehabilitation more frequently than group A (P = 0.047 and P < 0.001, respectively). Multivariate analysis confirmed that age was not related to postoperative mortality (P = 0.258), morbidity (P = 0.912) and overall survival (P = 0.658), but it was related to type of discharge (P < 0.001). The present study seems to suggest that a pancreaticoduodenectomy is a feasible and safe procedure, even in elderly and very elderly patients even if the latter require a longer period of rehabilitation.
authors.affiliation: Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti N.9, 40138, Bologna, Italy. riccardo.casadei@aosp.bo.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Casadei
authors.affiliation: Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti N.9, 40138, Bologna, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Taffurelli
authors.affiliation: Department of Surgery, San Giovanni Battista, Molinette Hospital, Turin, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Silvestri
authors.affiliation: Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti N.9, 40138, Bologna, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ricci
authors.affiliation: Department of Surgery, San Giovanni Battista, Molinette Hospital, Turin, Italy.
authors.forename: Donata
authors.initials: D
authors.lastname: Campra
authors.affiliation: Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti N.9, 40138, Bologna, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Minni
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007558:Italy / Q000453:epidemiology; D007565:Jaundice / Q000453:epidemiology; D008297:Male; D015999:Multivariate Analysis; D010185:Pancreatic Fistula / Q000453:epidemiology; D016577:Pancreaticoduodenectomy / Q000534:rehabilitation; D010351:Patient Discharge; D011182:Postoperative Care; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000453:epidemiology; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Elderly; Pancreaticoduodenectomy; Periampullary neoplasms