Outcomes of Pancreatic Surgery in Patients Older than 70 Years

Schlottmann, Francisco; Iovaldi, Mario L.; Capitanich, Pablo; McCormack, Lucas

doi:10.1016/j.cireng.2015.03.007

Cited by 3 publications

(5 citation statements)

References 16 publications

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“…The CCS patients had a similar DP proportion when compared to the patients of HVAS (Table 2 ; Additional file 1 ) [ 10 – 12 , 14 – 16 ]. The CCS patients had a significantly higher ASA ≥ 3 proportion than the patients of HVAS (Table 2 ; Additional file 2 ) [ 11 , 12 , 15 , 16 ]. The CCS patients had a similar 90-day mortality proportion when compared to the patients of HVAS (Table 2 ; Additional file 3 ) [ 10 , 15 ].…”

Section: Resultsmentioning

confidence: 98%

“…The CCS patients had a lower SSI proportion than the patients of HVAS (Table 2 ; Additional file 6 ) [ 10 , 12 , 15 ]. The CCS patients had a similar DGE proportion compared to the patients of HVAS (Table 2 ; Additional file 7 ) [ 10 – 13 , 15 , 16 ]. The CCS patients had a lower CD III–IV proportion than the patients of HVAS (Table 2 ; Additional file 8 ) [ 11 , 12 , 14 ].…”

Section: Resultsmentioning

confidence: 99%

Section: All Pancreatic Surgical Patientsmentioning

confidence: 99%

“…The literature search found seven relevant mixed pancreatic surgical citations from HVAS [10][11][12][13][14][15][16]. The CCS patients had a similar PD proportion when compared to the patients of HVAS (Table 2; Additional file 1) [10][11][12][14][15][16]. The CCS patients had a similar DP proportion when compared to the patients of HVAS (Table 2; Additional file 1) [10][11][12][14][15][16].…”

Section: All Pancreatic Surgical Patientsmentioning

confidence: 99%

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Establishing an open and robotic pancreatic surgery program in a level 1 trauma center community teaching hospital and comparing its outcomes to high-volume academic center outcomes: a retrospective review

et al. 2022

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Background The debate of whether to centralize hepato-pancreato-biliary surgery has been ongoing. The principal objective was to compare outcomes of a community pancreatic surgical program with those of high-volume academic centers. Methods The current pancreatic surgical study occurred in an environment where (1) a certified abdominal transplant surgeon performed all surgeries; (2) complementary quality enhancement programs had been developed; (3) the hospital’s trauma center had been verified; and (4) the hospital’s surgical training had been accredited. Pancreatic surgical outcomes at high-volume academic centers were obtained through PubMed literature searches. Articles were selected if they described diverse surgical procedures. Two-tailed Fisher exact and mid-P tests were used to perform 2 × 2 contingency analyses. Results The study patients consisted of 64 consecutive pancreatic surgical patients. The study patients had a similar pancreaticoduodenectomy proportion (59.4%) when compared to literature patients (66.8%; P = 0.227). The study patients also had a similar distal pancreatectomy proportion (25.0%) when compared to literature patients (31.9%; P = 0.276). The study patients had a significantly higher American Society of Anesthesiologists physical status ≥ 3 proportion (100%) than literature patients (28.1%; P < 0.001). The 90-day study mortality proportion (0%) was similar to the literature proportion (2.3%; P = 0.397). The study postoperative pancreatic fistula proportion was lower (3.2%), when compared to the literature proportion (18.4%; P < 0.001; risk ratio = 5.8). The study patients had a lower reoperation proportion (3.1%) than the literature proportion (8.7%; mid-P = 0.051; risk ratio = 2.8). The study patients had a lower surgical site infection proportion (3.1%) than those in the literature (21.1%; P < 0.001; risk ratio = 6.8). The study patients had equivalent delayed gastric emptying (15.6%) when compared to literature patients (10.6%; P = 0.216). The study patients had decreased Clavien–Dindo grades III–IV complications (10.9%) compared to the literature patients (21.8%; mid-P = 0.018). Lastly, the study patients had a similar readmission proportion (20.3%) compared to literature patients (18.4%; P = 0.732). Conclusion Despite pancreatic surgical patients having greater preoperative medical comorbidities, the current community study outcomes were comparable to or better than high-volume academic center results.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: All Pancreatic Surgical Patientsmentioning

confidence: 99%

Section: All Pancreatic Surgical Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Establishing an open and robotic pancreatic surgery program in a level 1 trauma center community teaching hospital and comparing its outcomes to high-volume academic center outcomes: a retrospective review

et al. 2022

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“…The difference in the cutoff age for the elderly has led to a significant heterogeneity in the various studies, making it hard to interpret the results with clarity. 13 Some studies set the age of 65 years as the cutoff for being defined as the elderly 14,15 , while others set the ages of 70 years 16,17 , 75 years 18,19 , or 80 years 20,21 as the standard. As per the definition of the elderly in Pakistan 2, 13 , 60 years was the cutoff used to compare the preoperative characteristics and outcomes in the current study.…”

Section: Discussionmentioning

confidence: 99%

Is age just a number or does it really affect the surgical and oncological outcomes after pancreatoduodenectomy?

Begum

Amjad²,

Shamoon³

et al. 2022

J Pak Med Assoc

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Objective: To review the impact of age on perioperative and postoperative outcomes in patients following pancreaticoduodenectomy. Method: The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data from January 2014 to December 2018 of all patients who underwent pancreatoduodenectomy. Postoperative morbidity and oncological outcomes were compared between patients aged 60 years in group A and those aged >60 years in group B. Data was analysed using SPSS 20. Results: Of the 161 patients, 103(64%) were males and 58(36%) were females. There were 117(73%) patients in group A; 72(61.5%) males and 45(38.5%) females with an overall mean age of 46±11 years. The remaining 44(27%) were in group B; 31(70.5%) males and 13(29.5%) females with an overall mean age of 67±05 years.The most common pathology was adenocarcinoma 130(81%), commonest site was periampullary 85(53%) and the most common pancreatic reconstruction technique employed was pancreaticogastrostomy 110(68%). Patients in group B had significantly higher comorbidities compared to those in group A (p<0.05). Estimated blood loss during surgery was significantly higher in group B (p=0.004). There was no significant difference in overall morbidity (p=0.856), reoperation (p=1.000), 30-day readmission rate (p=0.097), 90-day mortality rate (p=0.324)) and overall survival (p=0.551) between the groups. Conclusion: Pancreatoduodenectomy could be performed in the elderly with comparable morbidity and oncological outcomes as younger patients. Comorbid conditions remained higher in elderly patients and preoperative optimisation may help improve postoperative outcomes. Key Words: Pancreatoduodenectomy. Outcomes in elderly, Age, Morbidity.

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Elderly patients had more severe postoperative complications after pancreatic resection: A retrospective analysis of 727 patients

Chen¹,

Ma²,

Wang³

et al. 2018

WJG

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AIMTo examine the impact of aging on the short-term outcomes following pancreatic resection (PR) in elderly patients.METHODSA retrospective cohort study using prospectively collected data was conducted at the China National Cancer Center. Consecutive patients who underwent PR from January 2004 to December 2015 were identified and included. ‘Elderly patient’ was defined as ones age 65 and above. Comorbidities, clinicopathology, perioperative variables, and postoperative morbidity and mortality were compared between the elderly and young patients. Univariate and multivariate analyses were performed using the Cox proportional hazard model for severe postoperative complications (grades IIIb-V).RESULTSA total of 454 (63.4%) patients were < 65-years-old and 273 (36.6%) patients were ≥ 65-years-old, respectively. Compared to patients < 65-years-old, elderly patients had worse American Society of Anesthesiologists scores (P = 0.007) and more comorbidities (62.6% vs 32.4%, P < 0.001). Elderly patients had more severe postoperative complications (16.8% vs 9.0%, P = 0.002) and higher postoperative mortality rates (5.5% vs 0.9%, P < 0.001). In the multivariate Cox proportional hazards model for severe postoperative complications, age ≥ 65 years [hazard ratio (HR) = 1.63; 95% confidence interval (CI): 1.18-6.30], body mass index ≥ 24 kg/m2 (HR = 1.20, 95%CI: 1.07-5.89), pancreaticoduodenectomy (HR = 4.86, 95%CI: 1.20-8.31) and length of operation ≥ 241 min (HR = 2.97; 95%CI: 1.04-6.14) were significant (P = 0.010, P = 0.041, P = 0.017 and P = 0.012, respectively).CONCLUSIONWe found that aging is an independent risk factor for severe postoperative complications after PR. Our results might contribute to more informed decision-making for elderly patients.

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Outcomes of Pancreatic Surgery in Patients Older than 70 Years

Cited by 3 publications

References 16 publications

Establishing an open and robotic pancreatic surgery program in a level 1 trauma center community teaching hospital and comparing its outcomes to high-volume academic center outcomes: a retrospective review

Establishing an open and robotic pancreatic surgery program in a level 1 trauma center community teaching hospital and comparing its outcomes to high-volume academic center outcomes: a retrospective review

Is age just a number or does it really affect the surgical and oncological outcomes after pancreatoduodenectomy?

Elderly patients had more severe postoperative complications after pancreatic resection: A retrospective analysis of 727 patients

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