title: Laparoscopic distal pancreatectomy in elderly patients: is it safe?
abstract: BACKGROUND
  Laparoscopic distal pancreatectomy (LDP) appears to be safe and effective as open distal pancreatectomy (ODP) for benign or borderline malignant lesion. However, studies comparing LDP with ODP in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of these two several approaches in elderly patients.
  
  
  METHODS
  A retrospective analysis was carried out by comparing laparoscopic (n = 7) and open (n = 15) distal pancreatectomy in elderly patients performed at the University of Naples "Federico II" and University of Perugia between January 2012 and December 2015. Demographic data, operative and postoperative outcomes were analyzed.
  
  
  RESULTS
  Demographic and tumor characteristics of laparoscopic and ODP were similar. There were also no significant differences in operating room time. Patients undergoing LDP had lower blood loss, first flatus time, diet start time and postoperative hospital stay. There were no significant differences in complication rates or 90-day mortality.
  
  
  CONCLUSIONS
  LDP is safe and feasible as ODP in selected elderly patients.
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Aprea
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: De Rosa
authors.affiliation: Division of General Surgery, Department of Surgical Sciences and Nephrology, School of Medicine, University of Naples Federico II, Naples, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Milone
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy. aldorocca@hotmail.it.
authors.forename: Aldo
authors.initials: A
authors.lastname: Rocca
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Bianco
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Massa
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Compagna
authors.affiliation: Division of Colorectal Surgery, Department of Clinical Sciences, Pelvic Floor Centre, Malmö University Hospital, Lund University, Lund, Sweden.
authors.forename: Louis Banka
authors.initials: LB
authors.lastname: Johnson
authors.affiliation: General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sanguinetti
authors.affiliation: General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Polistena
authors.affiliation: General Surgery and Surgical Specialties Unit, Medical School, S. Maria University Hospital, University of Perugia, Terni, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Avenia
authors.affiliation: Division of General Surgery, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, via S. Pansini, 5, 80131, Naples, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Distal pancreasectomy; Elderly; Robotic surgery