Ann Surg Treat Res.  2016 Dec;91(6):288-294. 10.4174/astr.2016.91.6.288.

The safety and risk factors of major hepatobiliary pancreatic surgery in patients older than 80 years

• Kim JH
• Min SK
• Lee H
• Hong G
• Lee HK

• KMID: 2360388
• DOI: http://doi.org/10.4174/astr.2016.91.6.288

Abstract

PURPOSE
Recently, the number of elderly patients has increased due to a longer life expectancy. Among these elderly patients, more octogenarians will be diagnosed with major hepatobiliary pancreatic (HBP) diseases. Therefore, we need to evaluate the safety and risk factors of major HBP surgery in patients older than 80 years.
METHODS
From January 2000 to April 2015, patients who underwent major HBP surgery were identified. The patients were divided into 2 groups according to their age at the time of surgery: Group O (≥80 years) and group Y (<80 years). The patient characteristics and intra- and postoperative outcomes were retrospectively investigated in the 2 groups.
RESULTS
The median age was 84 years (range, 80-95 years) in group O and 61 years (range, 27-79 years) in group Y. group O had worse American Society of Anesthesiologists (ASA) physical status (ASA ≥ III: 23% vs. 7%, P = 0.002) and was associated with a higher rate of hypertension and heart problems as comorbidities. There were significant differences in albumin and BUN, favoring group Y. The length of intensive care unit stay was longer in group O, whereas the overall complication and mortality rates did not show statistical difference. But, there was a significant difference in systemic complication of both Clavien-Dindo classification grade ≥II and ≥III as complications were divided into surgical site complication and systemic complication.
CONCLUSION
Major HBP surgery can be performed safely in patients older than 80 years if postoperative management is appropriately provided.

Keyword

Aged; Safety; Postoperative complications; Mortality

MeSH Terms

Aged
Aged, 80 and over
Classification
Comorbidity
Heart
Humans
Hypertension
Intensive Care Units
Life Expectancy
Mortality
Postoperative Complications
Retrospective Studies
Risk Factors*

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