[Duodenopancreatectomy in the elderly. Evaluation of results]. / Duodenopancreatectomía en ancianos. Evaluación de resultados.

ABSTRACT

INTRODUCTION: With the increase in life expectancy, more and more resectable periampullary tumours are being diagnosed in the geriatric population. Despite the decrease in post-operative mortality, there continues to be a debate on the risk-benefit of cephalic duodenopancreatectomy (CPD) in the elderly. OBJECTIVE: To analyse the morbidity and mortality of CPD in patients over 70 years-old. DESIGN: Prospective observational study. PATIENTS A total of 54 duodenopancreatectomies were performed between January 2005 and December 2010. Two groups of patients were compared Group 1 (patients>70 years-old, n 24), and Group 2 (patients<70 years-old, n 30). The morbidity and mortality, transfusion, reinterventions, mean hospital stay, and survival were analysed. RESULTS: The>70 years group included more ASA 2 and 3 patients (P=.010), and had a higher number of previous medical problems per patient (P=.037). The post-operative mortality was higher in the older age group, although the difference was not significant (8.3 vs 3.3%). There were also no significant differences in post-operative morbidity (45.8 v. 46.6%), reintervention rate (16.6 vs 13.3%), length of hospital stay (18 vs 13%), and survival at 6 and 12 months (84 and 72% vs 90 and 86%). CONCLUSIONS: Age, in itself, does not seem to be a contraindication for CPD, but the elderly do have a higher risk of complications due to the physiological changes associated with ageing. The disparity of results demonstrates the need for more population studies at national level that may give an overall view of morbidity and mortality in CPD.