Department of Surgery, Hachioji Digestive Disease Hospital, 177-3 Yorozu-cho, Hachioji, Tokyo 192-0903, Japan.
Surg Today. 2013 Jun;43(6):620-4. doi: 10.1007/s00595-012-0383-6. Epub 2012 Oct 27.
Although pancreaticoduodenectomy has been recognized in the past for its severe complications, improvements in operative methods and perioperative management have made it a safe procedure. Therefore, pancreaticoduodenectomy can be performed in elderly patients, and our experience and outcomes are described in this report.
We retrospectively investigated 142 patients in whom pancreaticoduodenectomy was performed without stenting tubes during pancreaticojejunostomy. The patients were classified into two groups: (A) those older and (B) younger than 75 years. The outcomes, including preoperative characteristics, intraoperative characteristics, postoperative complications and mortality, are herein reported. Continuous variables were compared using Student's t test and the Chi-square test.
There were no differences between groups A and B in terms of sex, operative time, amount of blood loss, performance status, soft pancreas rate, disease distribution and operative procedure. Comorbidities in groups A and B were statistically different. Regarding the preoperative status, the elderly patients exhibited lower serum albumin and hemoglobin levels than the younger patients. There were no differences in mortality (0 vs. 0 %), morbidity (24.3 vs. 29.5 %, p = 0.362), postoperative hospital days or major complications such as pancreatic fistula development, delayed gastric emptying, intra-abdominal abscess development, biliary fistula formation and postpancreatectomy hemorrhage.
Pancreaticoduodenectomy can be safely performed in elderly as well as younger patients.
尽管胰十二指肠切除术过去因其严重的并发症而备受关注，但手术方法和围手术期管理的改进使其成为一种安全的手术。因此，胰十二指肠切除术可以在老年患者中进行，我们在此报告我们的经验和结果。
我们回顾性研究了 142 例在胰肠吻合术中未使用支架管进行胰十二指肠切除术的患者。患者分为两组：（A）年龄较大组和（B）年龄小于 75 岁组。报告了手术结果，包括术前特征、术中特征、术后并发症和死亡率。连续变量采用 Student's t 检验和卡方检验进行比较。
两组在性别、手术时间、出血量、身体状况、软胰腺发生率、疾病分布和手术方式方面无差异。两组的合并症存在统计学差异。在术前状态方面，老年患者的血清白蛋白和血红蛋白水平低于年轻患者。两组的死亡率（0 与 0%，p=0.362）、发病率（24.3%与 29.5%，p=0.362）、术后住院天数或主要并发症如胰瘘、胃排空延迟、腹腔脓肿形成、胆瘘形成和胰切除术后出血无差异。
胰十二指肠切除术可以安全地应用于老年和年轻患者。
