title: Perioperative outcomes and survival in elderly patients undergoing laparoscopic distal pancreatectomy.
abstract: BACKGROUND
  The outcomes following laparoscopic distal pancreatectomy (LDP) in elderly patients have not been widely reported to date. This study aimed to analyze perioperative and oncologic outcomes in patients aged ≥70 years (elderly group) and compare with those <70 years (non-elderly group).
  
  
  METHODS
  From April 1997 to September 2015, 402 consecutive patients with lesions in the body and tail of the pancreas underwent LDP at Rikshospitalet, Oslo University Hospital.
  
  
  RESULTS
  Of these, 118 (29.4%) were elderly, whereas 284 (70.6%) were non-elderly. Despite higher rate of comorbidities and American Society of Anesthesiologists score (P = 0.001 and 0.001, respectively), elderly patients had lower postoperative morbidity, pancreatic fistula (PF) and readmission rates, compared with non-elderly (P = 0.032, 0.001 and 0.025, respectively). Spleen-preserving LDP (SPLDP) resulted in similar postoperative outcomes in the two groups. Elderly patients with pancreatic ductal adenocarcinoma (PDAC) were comparable to non-elderly in terms of median and 3-year survival (20.2 vs. 19 months (P = 0.94, log-rank) and 26.7% vs. 34.3%, respectively).
  
  
  CONCLUSIONS
  Both LDP and SPLDP are safe in patients aged ≥70 years, providing outcomes similar to those in younger group. Elderly patients with PDAC can benefit from LDP, since age itself is not associated with decreased survival after surgery.
authors: The Interventional Centre, Oslo University Hospital, 0027, Oslo, Norway.|Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.|Department of Surgery, Yerevan State Medical University, Yerevan, Armenia.
authors: Mushegh A
authors: MA
authors: Sahakyan
authors: The Interventional Centre, Oslo University Hospital, 0027, Oslo, Norway.|Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.|Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.
authors: Bjørn
authors: B
authors: Edwin
authors: The Interventional Centre, Oslo University Hospital, 0027, Oslo, Norway.|Department of Digestive Surgery, Akershus University Hospital, University of Oslo, Lørenskog, Norway.
authors: Airazat M
authors: AM
authors: Kazaryan
authors: The Interventional Centre, Oslo University Hospital, 0027, Oslo, Norway.|Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.
authors: Leonid
authors: L
authors: Barkhatov
authors: Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.|Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.
authors: Trond
authors: T
authors: Buanes
authors: Department of Digestive Surgery, Akershus University Hospital, University of Oslo, Lørenskog, Norway.
authors: Dejan
authors: D
authors: Ignjatovic
authors: Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.
authors: Knut Jørgen
authors: KJ
authors: Labori
authors: Department of HPB Surgery, Oslo University Hospital, Oslo, Norway.
authors: Bård Ingvald
authors: BI
authors: Røsok
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D002423:Cause of Death; D015331:Cohort Studies; D018572:Disease-Free Survival; D015577:Geriatric Assessment; D006785:Hospitals, University; D006801:Humans; D007431:Intraoperative Complications / Q000401:mortality / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009664:Norway; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis
keywords: Adenocarcinoma; Elderly; Laparoscopy; Pancreatectomy; Survival