The Impact of Analysis of Age for Pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGWei , LINHai , HANWei , CHENGKun , GENCheng , RUIJian-rui ,  CHENQi-long

Department of Pancreatic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uyghur Autonomous Region, China;

Corresponding author：

CHENQi-long, Email: chenqilong651003@sohu.com

Keywords：

Age; Pancreaticoduodenectomy; Risk factor

DOI：

10.7507/1007-9424.20160218

Video：

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Objective To investigate the age of patients can be the independence factor to affect the feasibility of pancreaticoduodenectomy. Methods The cases in the First Affiliated Hospital, Xinjiang Medical University from Feb. 2011 to Feb. 2015 were retrospectively analyzed, and divided into six groups according to age < 50, 50≤age < 60, 60≤age < 70, 70≤age < 75, 70≤age < 80, and≥80 years old. The complications, hospitalization days, and mortality rates for six groups were analyzed. Results The differences in ASA classification (P < 0.001), hypertension (P < 0.001), coronary heart disease (P=0.001), diabetes mellitus (P < 0.001), heart failure (P=0.001), respiratory failure (P=0.037), postoperative hospitalization days (P=0.014), and delayed gastric emptying grade C (P=0.006) had statistical significance, and pancreatic fistula (P=0.058), postoperative bleeding (P=0.786), and mortality (P=0.125) of the different age groups had no significant difference. Conclusion Age is not the independent risk factor to affect the feasibility of pancreaticoduodenectomy, but the strictly preoperative comorbidities assessment is necessary.

Citation： ZHANGWei, LINHai, HANWei, CHENGKun, GENCheng, RUIJian-rui, CHENQi-long. The Impact of Analysis of Age for Pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(7): 843-846. doi: 10.7507/1007-9424.20160218 Copy

1.	Delcore R, Thomas JH, Hermreck AS. Pancreaticoduodenectomy for malignant pancreatic and periampullary neoplasms in elderly patients. Am J Surg, 1991, 162(6): 532-536.
2.	Scurtu R, Bachellier P, Oussoultzoglou E, et al. Outcome after pancreaticoduodenectomy for cancer in elderly patients. J Gastrointest Surg, 2006, 10(6): 813-822.
3.	Chen Y, Hao J, Ma W, et al. Improvement in treatment and outcome of pancreatic ductal adenocarcinoma in north China. J Gastrointest Surg, 2011, 15(6): 1026-1034.
4.	Bachellier P, Nakano H, Oussoultzoglou PD, et al. Is pancreaticoduo-denectomy with mesentericoportal venous resection safe and worth-while? Am J Surg, 2001, 182(2): 120-129.
5.	Kang CM, Kim JY, Choi GH, et al. Pancreaticoduodenectomy of pancreatic ductal adeno-carcinoma in the elderly. Yonsei Med J, 2007, 48(3): 488-494.
6.	Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery, 2005, 138(1): 8-13.
7.	Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery, 2007, 142(1): 20-25.
8.	Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2007, 142(5): 761-768.
9.	徐新保, 张洪义, 张辉, 等. 70岁以上高龄患者胰十二指肠切除术21例分析.临床外科杂志, 2010, 18(2): 101-103.
10.	叶振伟, 王在国, 林志强, 等.胰十二指肠切除术后胃瘫的诊治策略.中国肿瘤外科杂志, 2012, 4(1): 18-20.
11.	王巍, 袁祖荣, 唐健雄, 等.高龄病人实施胰十二指肠切除术危险因素的分析.外科理论与实践, 2009, 14(5): 530-533.
12.	谢学海, 杨尹默, 田孝东, 等.胰十二指肠切除术后围手术期并发症的风险因素.中华肝胆外科杂志, 2008, 14(7): 455-459．.
13.	De la Fuente SG, Bennett KM, Pappas TN, et al. Pre-and intraoper-ative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy. HPB (Oxford), 2011, 13(12): 887-892.
14.	Suc B, Msika S, Piccinini M, et al. Octreotide in the prevention of intra-abdominal complications following elective pancreatic resection: a prospective, multicenter randomized controlled trial. Arch Surg, 2004, 139(3): 288-295.
15.	Khan S, Sclabas G, Lombardo KR, et al. Pancreatoduodenectomy for ductal adenocarcinoma in the very elderly, is it safe and justified? Gastrointest Surg, 2010, 14(11): 1826-1831.
16.	Haigh PI, Bilimoria KY, DiFronzo LA. Early postoperative outcomes after pancreaticoduo-denectomy in the elderly. Arch Surg, 2011, 146(6): 715-723.
17.	Yeo CJ, Cameron JL, Lillemoe KD, et al. Pancreaticodenectomy with or without distal gastrectomy and extended retroperitoneal lympha-denectomy for periampullary adenoc-arcinoma, part 2: randomized controlled trial evaluating survival, morbidity, and mortality. Ann Surg, 2002, 236(3): 355-368.
18.	Tani M, Kawai M, Hirono S, et al. A pancreaticoduodenectomy is acceptable for periampulla ry tumors in the elderly, even in patients over 80 years of age. Hepatobiliary Pancreat Surg, 2009, 16(5): 675-680.
19.	Winter JM, Cameron JL, Campbell KA, et al. 1 423 pancreaticoduo-denectomies for pancreatic cancer: A single-institution experience. J Gastrointest Surg, 2006, 10(9): 1199-1211.
20.	Castleberry AW, White RR, De La Fuente SG, et al. The impact of vascular resection on early postoperative outcomes after pancrea-ticoduodenectomy: an analysis of the American College of Surgeons National Surgical Quality Improvement Program database. Ann Surg Oncol, 2012, 19(13): 4068-4077.
21.	Chua TC, Saxena A. Extended pancreaticoduodenectomy with vascular resection for pancreatic cancer: a systematic review. J Gastrointest Surg, 2010, 14(9): 1442-1452.
22.	Zhou GW, Wu WD, Xiao WD, et al. Pancreatectomy combined with superior mesenteric-portal vein resection: report of 32 cases. Hepatobiliary Pancreat Dis Int, 2005, 4(1): 130-134.
23.	戴存才, 苗毅, 刘训良, 等. 80岁以上胰十二指肠切除术体会.中华肝胆外科杂志, 2006, 12 (2): 83-85.
24.	冯变喜.高龄病人胰十二指肠切除术32例.中华肝胆外科杂志, 2007, 13(12): 854-855.
25.	苗毅, 徐泽宽, 钱祝银, 等.老年患者胰十二指肠切除术的体会.江苏医药, 2004, 30(7): 529-530.

1. Delcore R, Thomas JH, Hermreck AS. Pancreaticoduodenectomy for malignant pancreatic and periampullary neoplasms in elderly patients. Am J Surg, 1991, 162(6): 532-536.
2. Scurtu R, Bachellier P, Oussoultzoglou E, et al. Outcome after pancreaticoduodenectomy for cancer in elderly patients. J Gastrointest Surg, 2006, 10(6): 813-822.
3. Chen Y, Hao J, Ma W, et al. Improvement in treatment and outcome of pancreatic ductal adenocarcinoma in north China. J Gastrointest Surg, 2011, 15(6): 1026-1034.
4. Bachellier P, Nakano H, Oussoultzoglou PD, et al. Is pancreaticoduo-denectomy with mesentericoportal venous resection safe and worth-while? Am J Surg, 2001, 182(2): 120-129.
5. Kang CM, Kim JY, Choi GH, et al. Pancreaticoduodenectomy of pancreatic ductal adeno-carcinoma in the elderly. Yonsei Med J, 2007, 48(3): 488-494.
6. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery, 2005, 138(1): 8-13.
7. Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): an International Study Group of Pancreatic Surgery (ISGPS) definition. Surgery, 2007, 142(1): 20-25.
8. Wente MN, Bassi C, Dervenis C, et al. Delayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS). Surgery, 2007, 142(5): 761-768.
9. 徐新保, 张洪义, 张辉, 等. 70岁以上高龄患者胰十二指肠切除术21例分析.临床外科杂志, 2010, 18(2): 101-103.
10. 叶振伟, 王在国, 林志强, 等.胰十二指肠切除术后胃瘫的诊治策略.中国肿瘤外科杂志, 2012, 4(1): 18-20.
11. 王巍, 袁祖荣, 唐健雄, 等.高龄病人实施胰十二指肠切除术危险因素的分析.外科理论与实践, 2009, 14(5): 530-533.
12. 谢学海, 杨尹默, 田孝东, 等.胰十二指肠切除术后围手术期并发症的风险因素.中华肝胆外科杂志, 2008, 14(7): 455-459．.
13. De la Fuente SG, Bennett KM, Pappas TN, et al. Pre-and intraoper-ative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy. HPB (Oxford), 2011, 13(12): 887-892.
14. Suc B, Msika S, Piccinini M, et al. Octreotide in the prevention of intra-abdominal complications following elective pancreatic resection: a prospective, multicenter randomized controlled trial. Arch Surg, 2004, 139(3): 288-295.
15. Khan S, Sclabas G, Lombardo KR, et al. Pancreatoduodenectomy for ductal adenocarcinoma in the very elderly, is it safe and justified? Gastrointest Surg, 2010, 14(11): 1826-1831.
16. Haigh PI, Bilimoria KY, DiFronzo LA. Early postoperative outcomes after pancreaticoduo-denectomy in the elderly. Arch Surg, 2011, 146(6): 715-723.
17. Yeo CJ, Cameron JL, Lillemoe KD, et al. Pancreaticodenectomy with or without distal gastrectomy and extended retroperitoneal lympha-denectomy for periampullary adenoc-arcinoma, part 2: randomized controlled trial evaluating survival, morbidity, and mortality. Ann Surg, 2002, 236(3): 355-368.
18. Tani M, Kawai M, Hirono S, et al. A pancreaticoduodenectomy is acceptable for periampulla ry tumors in the elderly, even in patients over 80 years of age. Hepatobiliary Pancreat Surg, 2009, 16(5): 675-680.
19. Winter JM, Cameron JL, Campbell KA, et al. 1 423 pancreaticoduo-denectomies for pancreatic cancer: A single-institution experience. J Gastrointest Surg, 2006, 10(9): 1199-1211.
20. Castleberry AW, White RR, De La Fuente SG, et al. The impact of vascular resection on early postoperative outcomes after pancrea-ticoduodenectomy: an analysis of the American College of Surgeons National Surgical Quality Improvement Program database. Ann Surg Oncol, 2012, 19(13): 4068-4077.
21. Chua TC, Saxena A. Extended pancreaticoduodenectomy with vascular resection for pancreatic cancer: a systematic review. J Gastrointest Surg, 2010, 14(9): 1442-1452.
22. Zhou GW, Wu WD, Xiao WD, et al. Pancreatectomy combined with superior mesenteric-portal vein resection: report of 32 cases. Hepatobiliary Pancreat Dis Int, 2005, 4(1): 130-134.
23. 戴存才, 苗毅, 刘训良, 等. 80岁以上胰十二指肠切除术体会.中华肝胆外科杂志, 2006, 12 (2): 83-85.
24. 冯变喜.高龄病人胰十二指肠切除术32例.中华肝胆外科杂志, 2007, 13(12): 854-855.
25. 苗毅, 徐泽宽, 钱祝银, 等.老年患者胰十二指肠切除术的体会.江苏医药, 2004, 30(7): 529-530.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Impact of Analysis of Age for Pancreaticoduodenectomy

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