Shyr Bor-Uei, Shyr Bor-Shiuan, Shih Mu-Shan, Chen Shih-Chin, Wang Shin-E, Shyr Yi-Ming
Division of General Surgery, Department of Surgery and Therapeutic and Research Center of Pancreatic Cancer, Taipei Veterans General Hospital, 10 Floor 201 Section 2 Shipai Road, Taipei, 112, Taiwan, ROC.
National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Updates Surg. 2025 Jan 15. doi: 10.1007/s13304-025-02082-8.
Impact of age on surgical and survival outcomes after combined robotic/open pancreaticoduodenectomy (CR/OPD) has not been extensively studied. This study aimed to evaluate the surgical and survival outcomes of patients aged < 50 years who underwent CR/OPD. A comparative study was conducted on patients who underwent CR/OPD divided into two groups: the young (age < 50 years) and the old (age ≥ 50 years). A total of 555 patients were included in this study, with 53 (9.5%) in the young group and 502 (90.5%) in the old group. Periampullary adenocarcinomas were less common in the young group (32.1% vs. 76.5%), whereas solid and pseudopapillary tumors (9.4% vs. 1.0%) and neuroendocrine tumors (15.1% vs. 3.6%) were more common. Soft pancreatic parenchyma (77.4% vs. 76.5%) and non-dilated (≤ 3 mm) pancreatic ducts (77.4% vs. 62.5%) were more prevalent in the young group. The young group had a shorter length of stay (median, 16 vs. 20 days). No significant differences were observed in the other surgical outcomes and risks, including postoperative pancreatic fistula (POPF) (7.5% vs. 8.0%). Survival outcomes for overall periampullary adenocarcinoma favored the young group, with a 5-year survival rate of 76.4% vs. 46.7% in the old group. In conclusion, RPD in the young patients (< 50 years) is associated with comparable surgical outcomes and favorable survival outcomes for periampullary adenocarcinoma compared with the older patients (≥ 50 years). These findings highlight the feasibility and safety of RPD in the young population, although the prevalence of soft pancreatic parenchyma and non-dilated pancreatic ducts was higher in the young group.
年龄对机器人辅助/开放联合胰十二指肠切除术（CR/OPD）术后手术及生存结局的影响尚未得到广泛研究。本研究旨在评估接受CR/OPD的年龄＜50岁患者的手术及生存结局。对接受CR/OPD的患者进行了一项对比研究，分为两组：年轻组（年龄＜50岁）和老年组（年龄≥50岁）。本研究共纳入555例患者，其中年轻组53例（9.5%），老年组502例（90.5%）。壶腹周围腺癌在年轻组中较少见（32.1%对76.5%），而实性假乳头状肿瘤（9.4%对1.0%）和神经内分泌肿瘤（15.1%对3.6%）在年轻组中更常见。年轻组软胰腺实质（77.4%对76.5%）和非扩张（≤3mm）胰管（77.4%对62.5%）更为普遍。年轻组住院时间较短（中位数，16天对20天）。在其他手术结局和风险方面，包括术后胰瘘（POPF）（7.5%对8.0%），未观察到显著差异。总体壶腹周围腺癌的生存结局有利于年轻组，5年生存率为76.4%，而老年组为46.7%。总之，与老年患者（≥50岁）相比，年轻患者（＜50岁）行RPD的手术结局相当，壶腹周围腺癌的生存结局良好。这些发现突出了RPD在年轻人群中的可行性和安全性，尽管年轻组软胰腺实质和非扩张胰管的患病率较高。
