A Study of Pancreatoduodenectomy in Elderly Patients 80 Years and Above

Wataru Fukushima, Kohji Konishi, Masahiko Tsuji, Hiroyuki Sahara, Hisashi Matsumoto, Naotaka Kadoya, Takao Taniya, Kazuhisa Yabushita, Yoshitaka Kuroda, Sumio Miwa*

Department of Surgery, Department of Clinicopathology*, Toyama Prefectural Central Hospital

Pancreatoduodenectomy was performed in 196 patients in our department during the past 12 years, and elderly patients over 80 years old accounted for 17 of these cases (8.7%). Preoperative complications, and the postoperative morbidity, and mortality rates of these 17 cases were investigated and compared with those of patients from 60 to 79 years old and less than 79 years old. Thirteen patients (76.5%) in the cases over 80 years old had a preoperative complicating diseases, and the incidence in them was significantly higher than in other groups. Complication by cardiovascular and pulmonary disease or renal dysfunction was especially frequent among the patients over 80 years old. Although the mean duration of surgery and mean blood loss in the patients over 80 years old were less than in other groups, postoperative morbidity and mortality in the patients over 80 years old were 58.5% and 35.3%, respectively, and these were significantly higher than in other groups. In the patients over 80 years old, operative morbidity and mortality rates during the first 6 years, 1980-1985, were 83.3% and 50.0%, respectively, whereas during the second 6 years, 1986-1991, these rates decreased to 45.5% and 27.3%, respectively. This seemed to be due to the stability of the operative procedure and the establishment of postoperative management. We believe that with careful peri-operative management and operative procedure pancreatoduodenectomy can be performed in elderly patients over 80 years old.

Key words
pancreatoduodenectomy, elderly patient 80 years and above

Reprint requests
Wataru Fukushima Second Department of Surgery, School of Medicine, Kanazawa University
13-1 Takara-machi, Kanazawa City, 920 JAPAN

Accepted
June 14, 1993

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