Perioperative outcomes and survival in elderly patients undergoing laparoscopic distal pancreatectomy. (January 2017)

• Record Type: Journal Article
• Authors: Sahakyan, Mushegh A.; Edwin, Bjørn; Kazaryan, Airazat M.; Barkhatov, Leonid; Buanes, Trond; Ignjatovic, Dejan; Labori, Knut Jørgen; Røsok, Bård Ingvald
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 24:Number 1(2017)
• Page Start: 42
• Page End: 48
• Publication Date: 2017-01
• Subjects: Adenocarcinoma -- Elderly -- Laparoscopy -- Pancreatectomy -- Survival; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.409
• Languages: English
• ISSNs: 1868-6974

Abstract

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. Abstract : Sahakyan and colleagues examined the perioperative and oncologic outcomes of laparoscopic distal pancreatectomy in elderly patients (≥70 years). Despite higher comorbidity rates in the elderly group, surgical outcomes were comparable with those in non‐elderly patients (<70 years), and survival among patients with ductal adenocarcinoma was similar in the two groups.