[Pancreatic resection in the elderly : Is the risk justified?]. / Pankreasresektionen im Alter : Ist das Risiko vertretbar?

ABSTRACT

BACKGROUND: Due to demographic changes and improved diagnostic and therapeutic options surgery in the elderly is an essential field of discussion in medicine. Working groups are becoming increasingly more concerned with the question whether old age is a risk factor for complex surgical procedures. OBJECTIVE: This study was carried out to help assess and evaluate the risk of pancreatic resection in the elderly. MATERIAL AND METHODS: In a retrospective analysis of a prospectively maintained database of pancreatic resections, data from a 4-year period were evaluated and analyzed. A division into two age groups was defined according to the literature with the age of 75 years being the dividing line. RESULTS: During the 4 years of the study 209 pancreatic resections were performed in 146 patients under the age of 75 years and 63 patients over the age of 75 years. A pancreatic head resection was performed in 133 patients, distal pancreatectomy in 57, pancreatectomy in 16 and segmental resection in 3 patients. The overall mortality rate was 2.4 %, only patients over the age of 75 years were affected and was not directly related to surgery in any of the cases. The risk of patients dying perioperatively was significantly increased over the age of 75 years as was the comorbidity rate. Regarding surgically related complications there were no differences between the two groups. CONCLUSION: Pancreatic resection in elderly patients > 75 years is justified because of the very low surgical morbidity and mortality which can now be achieved in experienced centers if comorbidities of patients are taken into account in the decision-making process. The age per se does not constitute a contraindication.