Casadei Riccardo, Taffurelli Giovanni, Silvestri Stefano, Ricci Claudio, Campra Donata, Minni Francesco
Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum, S.Orsola-Malpighi Hospital, University of Bologna, Via Massarenti N.9, 40138, Bologna, Italy.
Department of Surgery, San Giovanni Battista, Molinette Hospital, Turin, Italy.
Updates Surg. 2015 Dec;67(4):439-47. doi: 10.1007/s13304-015-0337-9. Epub 2015 Nov 27.
The aim of this study is to evaluate the role of age after pancreaticoduodenectomy. This is a retrospective study of 223 patients who underwent pancreaticoduodenectomy for periampullary diseases. Three age groups of patients were compared: ≤70 years of age (group A); between 71 and 79 years of age (group B) and 80 years of age or older (group C). The primary endpoint was the postoperative mortality rate. Secondary endpoints were the overall postoperative morbidity, postoperative pancreatic fistula, postoperative pancreatic haemorrhage, bile leakage, delayed gastric emptying rates, the length of hospital stay, intensive care unit stay, the type of discharge from hospital, reoperation rate and overall survival. Uni-multivariate analyses and Kaplan-Meier curve were carried out. At univariate analysis, only the type of discharge from hospital showed that group B and C patients required a period of rehabilitation more frequently than group A (P = 0.047 and P < 0.001, respectively). Multivariate analysis confirmed that age was not related to postoperative mortality (P = 0.258), morbidity (P = 0.912) and overall survival (P = 0.658), but it was related to type of discharge (P < 0.001). The present study seems to suggest that a pancreaticoduodenectomy is a feasible and safe procedure, even in elderly and very elderly patients even if the latter require a longer period of rehabilitation.
本研究的目的是评估胰十二指肠切除术后年龄的作用。这是一项对223例因壶腹周围疾病接受胰十二指肠切除术患者的回顾性研究。比较了三组年龄患者：≤70岁（A组）；71至79岁（B组）和80岁及以上（C组）。主要终点是术后死亡率。次要终点是总体术后发病率、术后胰瘘、术后胰出血、胆漏、胃排空延迟率、住院时间、重症监护病房停留时间、出院类型、再次手术率和总生存率。进行了单变量和多变量分析以及Kaplan-Meier曲线分析。在单变量分析中，仅出院类型显示B组和C组患者比A组更频繁地需要一段时间的康复（分别为P = 0.047和P < 0.001）。多变量分析证实年龄与术后死亡率（P = 0.258）、发病率（P = 0.912）和总生存率（P = 0.658）无关，但与出院类型有关（P < 0.001）。本研究似乎表明，即使在老年和高龄患者中，胰十二指肠切除术也是一种可行且安全的手术，尽管后者需要更长时间的康复。
