Sperti Cosimo, Moletta Lucia, Pozza Gioia
Cosimo Sperti, Lucia Moletta, Gioia Pozza, Department of Surgery, Oncology and Gastroenterology, 3 Surgical Clinic, University of Padua, 35128 Padua, Italy.
World J Gastrointest Oncol. 2017 Jan 15;9(1):30-36. doi: 10.4251/wjgo.v9.i1.30.
The aging of the population results in a rise of number of elderly patients (aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34.9% and 13.2% respectively, with a mean length of hospital stay of 18 d. These features appear higher in older patients compared to the younger counterpart. Less than 50% of patients underwent adjuvant therapy after operation. Long-term survival is reported not significantly different in aged 80 years and older patients, with a median overall survival time of 17.6 mo. The quality of life after pancreatic resection is only sporadically evaluated but, when considered, it highlights the need of health facility service after operation for these "frail" patients. Prospective studies on the quality of life of pancreatectomized octogenarians are welcome. Proper selection of patients, geriatric assessment with multidisciplinary approach, centralization of pancreatic surgery in high-volume centres and rehabilitation programs after surgery appear to be crucial points in order to improve surgical treatments of pancreatic tumors in very elderly patients.
人口老龄化导致胰腺或壶腹周围癌老年患者（80岁及以上）数量增加，最终可能会对这类复杂患者实施更多的胰腺切除术。然而，八旬老人胰腺切除术后的早期和长期结果仍存在争议，这可能会给外科医生处理这类患者带来困扰。对已报道经验的评估表明，几乎所有作者都认为，尽管总体发病率和死亡率分别为34.9%和13.2%，平均住院时间为18天，但胰腺切除术在老年人群中可以安全进行。与年轻患者相比，这些特征在老年患者中似乎更高。术后接受辅助治疗的患者不到50%。据报道，80岁及以上患者的长期生存率没有显著差异，中位总生存时间为17.6个月。胰腺切除术后的生活质量仅偶尔得到评估，但一旦考虑到这一点，就会凸显出这些“体弱”患者术后对医疗设施服务的需求。欢迎对八旬老人胰腺切除术后的生活质量进行前瞻性研究。为了改善高龄患者胰腺肿瘤的手术治疗，正确选择患者、采用多学科方法进行老年评估、将胰腺手术集中在大容量中心以及术后康复计划似乎是关键要点。
