Korean J Hepatobiliary Pancreat Surg.  2011 Nov;15(4):248-253. 10.14701/kjhbps.2011.15.4.248.

The impact of old age on surgical outcomes after pancreaticoduodenectomy for distal bile duct cancer

• Shin JW
• Ahn KS
• Kim YH
• Kang KJ
• Lim TJ

• KMID: 2244133
• DOI: http://doi.org/10.14701/kjhbps.2011.15.4.248

Abstract

BACKGROUNDS/AIMS
To compare surgical results and survival of two groups of patients, age > or =70 vs. age <70, who underwent pancreaticoduodenectomy and to identify the safety of this procedure for elderly patients for the treatment of distal common bile duct (CBD) cancer.
METHODS
Between January 2003 and December 2009, 55 patients who underwent pancreaticoduodenectomy for the treatment of distal CBD cancer at Keimyung University Dong San Medical Center were enrolled in our study.
RESULTS
Of 55 patients, 28 were male and 27 female. Nineteen were over 70 years old (older group) and 36 were below 70 years (younger group). The mean ages of the two groups of patients were 73.5 years and 60.5 years respectively. Although patients of the older group had significantly more comorbid diseases, perioperative results including operation time, amount of intraoperative bleeding, duration of postoperative hospital stay and postoperative complications were not significantly different. A higher level (more than 5 mg/dl) of preoperative initial bilirubin showed significant correlations with operative morbidity by univariate analysis, and age was not an independent risk factor of operative morbidity. Overall 5 year survival of older and younger groups were 45.9% and 39.5% respectively (p=0.671) and disease-free 5-year survival were 31.7% and 31.1%, respectively (p=0.942).
CONCLUSIONS
Surgical outcomes of elderly patients were similar to those of younger patients, despite a higher incidence of comorbid disease. This results shows that pancreaticoduodenectomy can be applied safely to elderly patients.

Keyword

Bile duct neoplasm; Old age; Pancreaticoduodenectomy

MeSH Terms

Aged
Bile
Bile Duct Neoplasms
Bile Ducts
Bilirubin
Common Bile Duct
Female
Hemorrhage
Humans
Incidence
Length of Stay
Male
Pancreaticoduodenectomy
Postoperative Complications
Risk Factors
Bilirubin

Figure

• 

  Fig. 1 Comparison of survival according to age group. (A) Cumulative overall survival in Older and Younger groups; the difference between the two groups was not statistically significant (p=0.671). (B) Cumulative disease-free survival in the two groups; the difference between the two groups was not statistically significant (p=0.942).

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