Early and Long-Term Morbidity and Mortality Following Pancreaticoduodenectomy for Periampullary Tumors in Elderly Patients
Annali Italiani di Chirurgia, cilt.95, sa.2, ss.235-245, 2024 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 95 Sayı: 2
- Basım Tarihi: 2024
- Doi Numarası: 10.62713/aic.3380
- Dergi Adı: Annali Italiani di Chirurgia
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.235-245
- Anahtar Kelimeler: elderly, morbidity, mortality, pancreaticoduodenectomy, periampullary tumor
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Aim: The growing elderly population is facing an increasing risk of cancers, consequently raising the pancreatic cancer surgery rate. This study aimed to determine whether advanced age is a risk factor for morbidity and mortality following pancreaticoduodenectomy (PD) for periampullary tumors. Materials and Methods: The present study included 90 patients who underwent PD for periampullary tumors. Patients were divided into two age-related groups, including those aged 60–74 years (n = 60) (Group 1) and those aged ≥75 years (n = 30) (Group 2). Each patient’s characteristics, perioperative features, morbidity, and long-term results were evaluated retrospectively. Results: In both univariate and multivariate logistic regression analyses, old age (≥75 years) was not a risk factor for morbidity and hospital mortality. The multivariate analysis demonstrated that male gender (p = 0.008), pancreatic duct diameter (<3 mm) (p < 0.001), and length of hospital stay (p = 0.005) were independent risk factors for pancreatic fistula post-operation and reoperation. Additionally, hospital mortality was significantly associated with reoperation (p = 0.011). The overall median survival was 27 ± 4.1 (18.8–35.1) months. Lymph node positivity (p < 0.001), neural tumor invasion (p = 0.026), and age ≥75 years (p = 0.045) were risk factors affecting the overall survival rate. Moreover, there was no statistically significant difference in terms of PD rates during the Coronavirus disease-19 (COVID-19) period among groups, and PD during this period was not related to the occurrence of pancreatic fistula. Conclusion: PD can be performed effectively in selected elderly patients with tolerable morbidity and mortality rates.