title: Perioperative Outcomes after Pancreaticoduodenectomy in Elderly Patients.
abstract: OBJECTIVE
  Pancreaticoduodenectomy (PD) is highly invasive and may be associated with critical to fatal complications. The purpose of this study is to demonstrate, using multivariate analysis of preoperative and intraoperative patient characteristics to determine risk factors for negative outcomes, that PD can be performed safely in the elderly.
  
  
  METHODS
  We enrolled 108 patients who underwent PD between October 2007 and December 2014. We compared perioperative outcomes such as the incidence of post-operative complications, duration of hospital stay, and mortality between elderly (group A; age ≥ 75 years, n = 44) and younger (group B; age < 75 years, n = 64) groups.
  
  
  RESULTS
  Death occurred in one patient (2.3%) in group A. There were no significant differences between the groups in rates of major complications, including pancreatic fistula (PF), delayed gastric emptying, intra-abdominal bleeding, pneumonia, or duration of hospital stay. Multivariate analysis revealed complications in elderly to be associated with hemoglobin concentration (P = 0.016), and PF to be associated with body mass index (P = 0.013) and soft pancreas (P = 0.005).
  
  
  CONCLUSIONS
  PD can be performed safely in elderly patients aged ≥ 75 years. However, PD indication for elderly having low hemoglobin concentration patients should be carefully selected.
authors.forename: Joji
authors.initials: J
authors.lastname: Watanabe
authors.forename: Takehiko
authors.initials: T
authors.lastname: Hanaki
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Arai
authors.forename: Naruo
authors.initials: N
authors.lastname: Tokuyasu
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Soichiro
authors.initials: S
authors.lastname: Honjo
authors.forename: Shinji
authors.initials: S
authors.lastname: Otani
authors.forename: Masahide
authors.initials: M
authors.lastname: Ikeguchi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D005260:Female; D015577:Geriatric Assessment; D006454:Hemoglobins / Q000032:analysis; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality; D018579:Patient Selection; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins