Clinical efficacy of laparoscopic pancreaticoduodenectomy in elderly patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GONG Shuai , ZHANG Xiuzhong , ZHANG Pengbo ,  ZHANG Chong , WU Nai , ZHANG Yi , REN Zeqiang

Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P. R. China;

Corresponding author：

ZHANG Chong, Email: zc1604@126.com

Keywords：

elderly patient; pancreaticoduodenectomy; laparoscope; complication

DOI：

10.7507/1007-9424.202006032

Video：

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Objective To explore the feasibility and application value of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients.Methods The clinical data of patients who underwent LPD from August 2016 to July 2019 were retrospectively analyzed. The patients were allocated into the elderly group (≥65 years old) and non-elderly group (<65 years old). The early surgical outcomes and postoperative complications of the two groups were compared.Results In this study, 69 cases of LPD were collected, including 42 cases in the elderly group and 27 cases in the non-elderly group. Compared with the non-elderly group, the proportion of patients complicated comorbidities was higher (P<0.05), albumin level was lower (P<0.05), and American Society of Anesthesiologists classification was higher (P<0.05) in the elderly group. There were no significant differences in the intraoperative conditions, postoperative recovery, and postoperative complications between the two groups (P>0.05), and there were no significant differences in the pathological results of postoperative malignant tumor between the two groups (P>0.05).Conclusions For elderly patients with over 65 years old, LPD is a safe and feasible surgical procedure for clinical practice. Meanwhile, early surgical outcomes are satisfactory, postoperative complications are not increased, and tumor cure effect can be achieved.

Citation： GONG Shuai, ZHANG Xiuzhong, ZHANG Pengbo, ZHANG Chong, WU Nai, ZHANG Yi, REN Zeqiang. Clinical efficacy of laparoscopic pancreaticoduodenectomy in elderly patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(4): 493-499. doi: 10.7507/1007-9424.202006032 Copy

1.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
2.	鲁超, 金巍巍, 牟一平, 等. 腹腔镜胰十二指肠切除术的学习曲线. 外科理论与实践, 2015, 20(6): 485-489.
3.	张建生, 王文斌, 刘建华, 等. 腹腔镜胰十二指肠切除术若干关键问题. 中国实用外科杂志, 2018, 38(7): 741-746.
4.	Khatkov I, Izrailov R, Tyutyunnik P, et al. One hundred and forty five total laparoscopic pancreatoduodenectomies: A single centre experience. Pancreatology, 2017, 17(6): 936-942.
5.	中华医学会外科学分会胰腺外科学组, 中国研究型医院学会胰腺病专业委员会, 中华外科杂志编辑部. 胰腺术后外科常见并发症诊治及预防的专家共识(2017). 中华外科杂志, 2017, 55(5): 328-334.
6.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
7.	王在国, 何润沛, 叶振伟, 等. 80岁以上高龄患者胰十二指肠切除术体会. 中国癌症防治杂志, 2014, 6(1): 67-69.
8.	王文斌, 闫长青, 吕海涛, 等. 腹腔镜与开腹胰十二指肠切除术疗效分析. 中华肝胆外科杂志, 2017, 23(2): 110-113.
9.	金继宽, 熊光冰, 朱峰, 等. 腹腔镜与开腹胰十二指肠切除术治疗胰头癌的近期疗效分析. 中华消化外科杂志, 2018, 17(7): 718-723.
10.	Zhang H, Lan X, Peng B, et al. Is total laparoscopic pancreaticoduodenectomy superior to open procedure? A meta-analysis. World J Gastroenterol, 2019, 25(37): 5711-5731.
11.	金巍巍, 徐晓武, 牟一平, 等. 腹腔镜胰十二指肠切除术单中心233例临床经验总结. 中华外科杂志, 2017, 55(5): 354-358.
12.	秦仁义, 马春阳, 王敏, 等. 腹腔镜胰十二指肠切除术胰肠吻合方式的选择. 外科理论与实践, 2017, 22(2): 106-109.
13.	Torphy RJ, Friedman C, Halpern A, et al. Comparing short-term and oncologic outcomes of minimally invasive versus open pancreaticoduodenectomy across low and high volume centers. Ann Surg, 2019, 270(6): 1147-1155.
14.	蔡合, 蔡云强, 李永彬, 等. 腹腔镜胰十二指肠切除术在年龄≥70岁患者中的安全性研究. 中华消化外科杂志, 2017, 16(10): 1029-1035.
15.	Sperti C, Moletta L, Pozza G. Pancreatic resection in very elderly patients: A critical analysis of existing evidence. World J Gastrointest Oncol, 2017, 9(1): 30-36.
16.	蔡云强, 夏青红, 高攀, 等. 加速康复外科在腹腔镜胰十二指肠切除术中的应用价值. 中华消化外科杂志, 2016, 15(6): 552-556.
17.	Gumbs AA, Rodriguez Rivera AM, Milone L, et al. Laparoscopic pancreatoduodenectomy: a review of 285 published cases. Ann Surg Oncol, 2011, 18(5): 1335-1341.
18.	Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.
19.	Zureikat AH, Moser AJ, Boone BA, et al. 250 robotic pancreatic resections: safety and feasibility. Ann Surg, 2013, 258(4): 554-559.
20.	Croome KP, Farnell MB, Que FG, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg, 2015, 19(1): 189-194.
21.	Stauffer JA, Coppola A, Villacreses D, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc, 2017, 31(5): 2233-2241.
22.	Palanivelu C, Senthilnathan P, Sabnis SC, et al. Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. Br J Surg, 2017, 104(11): 1443-1450.

1. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
2. 鲁超, 金巍巍, 牟一平, 等. 腹腔镜胰十二指肠切除术的学习曲线. 外科理论与实践, 2015, 20(6): 485-489.
3. 张建生, 王文斌, 刘建华, 等. 腹腔镜胰十二指肠切除术若干关键问题. 中国实用外科杂志, 2018, 38(7): 741-746.
4. Khatkov I, Izrailov R, Tyutyunnik P, et al. One hundred and forty five total laparoscopic pancreatoduodenectomies: A single centre experience. Pancreatology, 2017, 17(6): 936-942.
5. 中华医学会外科学分会胰腺外科学组, 中国研究型医院学会胰腺病专业委员会, 中华外科杂志编辑部. 胰腺术后外科常见并发症诊治及预防的专家共识(2017). 中华外科杂志, 2017, 55(5): 328-334.
6. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
7. 王在国, 何润沛, 叶振伟, 等. 80岁以上高龄患者胰十二指肠切除术体会. 中国癌症防治杂志, 2014, 6(1): 67-69.
8. 王文斌, 闫长青, 吕海涛, 等. 腹腔镜与开腹胰十二指肠切除术疗效分析. 中华肝胆外科杂志, 2017, 23(2): 110-113.
9. 金继宽, 熊光冰, 朱峰, 等. 腹腔镜与开腹胰十二指肠切除术治疗胰头癌的近期疗效分析. 中华消化外科杂志, 2018, 17(7): 718-723.
10. Zhang H, Lan X, Peng B, et al. Is total laparoscopic pancreaticoduodenectomy superior to open procedure? A meta-analysis. World J Gastroenterol, 2019, 25(37): 5711-5731.
11. 金巍巍, 徐晓武, 牟一平, 等. 腹腔镜胰十二指肠切除术单中心233例临床经验总结. 中华外科杂志, 2017, 55(5): 354-358.
12. 秦仁义, 马春阳, 王敏, 等. 腹腔镜胰十二指肠切除术胰肠吻合方式的选择. 外科理论与实践, 2017, 22(2): 106-109.
13. Torphy RJ, Friedman C, Halpern A, et al. Comparing short-term and oncologic outcomes of minimally invasive versus open pancreaticoduodenectomy across low and high volume centers. Ann Surg, 2019, 270(6): 1147-1155.
14. 蔡合, 蔡云强, 李永彬, 等. 腹腔镜胰十二指肠切除术在年龄≥70岁患者中的安全性研究. 中华消化外科杂志, 2017, 16(10): 1029-1035.
15. Sperti C, Moletta L, Pozza G. Pancreatic resection in very elderly patients: A critical analysis of existing evidence. World J Gastrointest Oncol, 2017, 9(1): 30-36.
16. 蔡云强, 夏青红, 高攀, 等. 加速康复外科在腹腔镜胰十二指肠切除术中的应用价值. 中华消化外科杂志, 2016, 15(6): 552-556.
17. Gumbs AA, Rodriguez Rivera AM, Milone L, et al. Laparoscopic pancreatoduodenectomy: a review of 285 published cases. Ann Surg Oncol, 2011, 18(5): 1335-1341.
18. Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.
19. Zureikat AH, Moser AJ, Boone BA, et al. 250 robotic pancreatic resections: safety and feasibility. Ann Surg, 2013, 258(4): 554-559.
20. Croome KP, Farnell MB, Que FG, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg, 2015, 19(1): 189-194.
21. Stauffer JA, Coppola A, Villacreses D, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc, 2017, 31(5): 2233-2241.
22. Palanivelu C, Senthilnathan P, Sabnis SC, et al. Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. Br J Surg, 2017, 104(11): 1443-1450.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical efficacy of laparoscopic pancreaticoduodenectomy in elderly patients

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