A pancreaticoduodenectomy is acceptable for periampullary tumors in the elderly, even in patients over 80 years of age

Abstract

Pancreaticoduodenectomy was considered to be a feasible surgical procedure for elderly patients who had a good performance status.

Randomized clinical trial of isolated Roux-en-Y versus conventional reconstruction after pancreaticoduodenectomy

“…Exclusion criteria were: age less than 20 years; severe co-morbidity (decompensated liver cirrhosis, chronic obstructive pulmonary disease stage IV according to the Global Initiative for Chronic Obstructive Lung Disease 20 , heart failure defined as New York Heart Association class IV 21 ); patient undergoing haemodialysis, or combined resection of other organs including colon and liver; and history of gastric and small/large bowel resection. There was no upper age limit 22 .…”

Subtotal stomach‐preserving pancreaticoduodenectomy (SSPPD) prevents postoperative delayed gastric emptying

“…The procedure of PPPD was introduced in order to reduce marginal ulceration and improve postoperative nutritional status post-PD [1]. However, with the exception of a few contrary reports [2][3][4], there has been an increased incidence of delayed gastric emptying (DGE) during the postoperative recovery period in patients who underwent PPPD (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43) as opposed to PD (6-31) [5][6][7][8][9][10]. Clinically, postoperative DGE decreases patient comfort, extends hospital stay, raises medical costs and increases the risk of aspiration pneumonia resulting from inhalation of regurgitated material [11].…”

Pancreaticoduodenectomy in the Elderly Patient: Age-Adapted Risk Assessment

“…However, it is not optimal for estimating operative risk in pancreatic surgery and is not specifically designed for the assessment of elderly patients [11] . It also fails to sufficiently differentiate between ASA 2 and 3, and is subject to the examiner's judgment [12] . This is supported by our results, which did not establish a positive correlation between a high ASA score and the overall complication rate.…”