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胰十二指肠切除术对于老年壶腹周围肿瘤患者是可行的,即使是80岁以上的患者。

A pancreaticoduodenectomy is acceptable for periampullary tumors in the elderly, even in patients over 80 years of age.

作者信息

Tani Masaji, Kawai Manabu, Hirono Seiko, Ina Shinomi, Miyazawa Motoki, Nishioka Ryohei, Shimizu Atsushi, Uchiyama Kazuhisa, Yamaue Hiroki

机构信息

Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama, 641-8510, Japan.

出版信息

J Hepatobiliary Pancreat Surg. 2009;16(5):675-80. doi: 10.1007/s00534-009-0106-6. Epub 2009 Apr 22.

Abstract

BACKGROUND

Although the mortality rates for pancreaticoduodenectomy have been reported to be low for periampullary tumors at high-volume centers, postoperative results still remain unclear for elderly patients over 80 years of age.

METHODS

This was a retrospective study of patients who underwent a pancreaticoduodenectomy and consisted of 335 patients who were treated for periampullary tumors between January 1994 and August 2008. The main outcomes were postoperative complications, mortality, and the length of hospital stay among the elderly patients, and they were analyzed in three groups: elderly patients over 80 years old, septuagenarians, and those under 70 years of age.

RESULTS

The performance status of elderly patients was lower than that of the patients under 70 (P < 0.05), and the elderly had a higher American Society of Anesthesiologists physical status classification score (P < 0.001) as well as low hemoglobin and serum albumin levels (P < 0.01 and P < 0.001, respectively). The incidence of delayed gastric emptying in the elderly was higher; however, there was no significant difference. The other outcomes in the elderly group were similar to those of the other groups.

CONCLUSIONS

Pancreaticoduodenectomy was considered to be a feasible surgical procedure for elderly patients who had a good performance status.

摘要

背景

尽管据报道,在高容量中心,壶腹周围肿瘤行胰十二指肠切除术的死亡率较低,但80岁以上老年患者的术后结果仍不明确。

方法

这是一项对接受胰十二指肠切除术患者的回顾性研究,包括1994年1月至2008年8月期间接受壶腹周围肿瘤治疗的335例患者。主要结局是老年患者的术后并发症、死亡率和住院时间,并将他们分为三组进行分析:80岁以上老年患者、70多岁患者和70岁以下患者。

结果

老年患者的体能状态低于70岁以下患者(P < 0.05),老年患者的美国麻醉医师协会身体状况分类评分较高(P < 0.001),血红蛋白和血清白蛋白水平较低(分别为P < 0.01和P < 0.001)。老年患者胃排空延迟的发生率较高;然而,差异无统计学意义。老年组的其他结局与其他组相似。

结论

对于体能状态良好的老年患者,胰十二指肠切除术被认为是一种可行的手术方法。

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