title: The safety and risk factors of major hepatobiliary pancreatic surgery in patients older than 80 years.
abstract: OBJECTIVE
  Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years.
  
  
  METHODS
  From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years). The patient characteristics and intra- and postoperative outcomes were retrospectively investigated in the 2 groups.
  
  
  RESULTS
  The median age was 84 years (range, 80-95 years) in group O and 61 years (range, 27-79 years) in group Y. group O had worse American Society of Anesthesiologists (ASA) physical status (ASA ≥ III: 23%vs. 7%, P = 0.002) and was associated with a higher rate of hypertension and heart problems as comorbidities. There were significant differences in albumin and BUN, favoring group Y. The length of intensive care unit stay was longer in group O, whereas the overall complication and mortality rates did not show statistical difference. But, there was a significant difference in systemic complication of both Clavien-Dindo classification grade ≥II and ≥III as complications were divided into surgical site complication and systemic complication.
  
  
  CONCLUSIONS
  Major HBP surgery can be performed safely in patients older than 80 years if postoperative management is appropriately provided.
authors.affiliation: Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Jong Hun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Seog Ki
authors.initials: SK
authors.lastname: Min
authors.affiliation: Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Huisong
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Geun
authors.initials: G
authors.lastname: Hong
authors.affiliation: Department of Surgery, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
authors.forename: Hyeon Kook
authors.initials: HK
authors.lastname: Lee
keywords: Aged; Mortality; Postoperative complications; Safety