Clinical feasibility of pancreaticoduodenectomy in different ages

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Surgical Oncology
Pancreatic Cancer
Presenter ZHANG Wei
Citation Annals of Oncology (2018) 29 (suppl_9): ix113-ix120. 10.1093/annonc/mdy441
Authors Z. Wei, T. Qing, D. Wei
  • Department Of Hepatopancreatobiliary Surgery, The Affiliated Tumor Hospital of Xinjiang Medical University, 830000 - Urumqi/CN

Abstract

Background

Pancreaticoduodenectomy (PD, Whipple procedure) is one of the most complex surgical procedures in the general surgery field. While older patients undergoing Whipple surgery are considered an especially important challenge. Accumulating clinical evidence indicates that the only treatment available to cure periampullary carcinoma and pancreatic head carcinoma is Whipple surgery. Whether this surgery, which involves multiple organ resection, is suitable for elderly patients or not remains unclear and controversial. The purpose of our study was to evaluate the correlation between age and security in pancreaticoduodenectomy, and further, to confirm whether age is an influential factor in PD safety.

Methods

A retrospective case-control study was applied in our research, which included 195 cases with ages from 25 to 86. Pancreatoduodenectomy was performed in all cases from February 2012 to February 2016. Age stratification (age<50, 50-<60, 60-<70, 70-<75, 75-<80, age≥80) was applied to divide all cases into six groups. The postoperative complications hospitalization days perioperative death, and reoperation rates were obtained through the case retrieval system. According to the data collection and analysis, the risks associated with PD surgery and complications between the six different age-groups were obtained.

Results

There was no significant difference in pancreatic fistula (P = 0.058), mortality (P = 0.125), and postoperative complications such as hemorrhage (P = 0.786) between the different age groups. LSR Multiple range analysis between the six age groups showed that there were significant differences between heart failure (P = 0.001), respiratory failure (P = 0.037), postoperative hospitalization days (P = 0.014) and delayed gastric emptying in C grade (P = 0.006).

Conclusions

Postoperative heart failure and respiratory failure have a tendency to rise with the age increase, largely related to increased preoperative incidence of cardiopulmonary diseases in older patients. Through sufficient preoperative assessment and careful treatment, elderly patients can benefit from PD surgery. Age is not an independent risk factor affecting the feasibility of pancreaticoduodenectomy.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Zhang Wei.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.