Nuzzo G, Clemente G, Greco F, Ionta R, Cadeddu F
Department of Surgical Sciences, Hepatobiliary Unit, Catholic University of the Sacred Heart, "A. Gemelli" Medical School, Rome, Italy.
J Surg Oncol. 2004 Dec 15;88(4):206-9. doi: 10.1002/jso.20147.
Early and late results of surgical palliation for unresectable periampullary neoplasms were evaluated in 24 patients older than 70 years and compared with the same results obtained from 33 younger patients. The two groups of patients were comparable, except for age. Biliary bypass associated to gastric bypass was the most common performed procedure.
No significant differences in the results (morbidity, mortality, and outcome) were found in the two groups of patients. In addition, the results of palliative surgery in the elderly were compared with those obtained from a comparable group of 35 patients palliated with endoscopic stent insertion: surgical palliation resulted in better long-term results.
This study provides evidence that the chronologic age is not a contra-indication for surgical palliation of periampullary neoplasms and that surgery provides a better quality of residual life.
对24例70岁以上无法切除的壶腹周围肿瘤患者进行手术姑息治疗的早期和晚期结果进行评估，并与33例年轻患者的相同结果进行比较。除年龄外，两组患者具有可比性。胆肠吻合联合胃旁路术是最常用的手术方式。
两组患者在结果（发病率、死亡率和预后）方面未发现显著差异。此外，将老年患者的姑息性手术结果与35例接受内镜支架置入术的类似患者组的结果进行比较：手术姑息治疗产生了更好的长期结果。
本研究提供了证据，表明实际年龄并非壶腹周围肿瘤手术姑息治疗的禁忌证，且手术可提供更好的剩余生活质量。
