Literature DB >> 23865843

Pancreaticoduodenectomy in elderly adults: is it justified in terms of mortality, long-term morbidity, and quality of life?

Fabian Gerstenhaber1, Julie Grossman, Nir Lubezky, Eran Itzkowitz, Ido Nachmany, Ronen Sever, Menahem Ben-Haim, Richard Nakache, Joseph M Klausner, Guy Lahat.   

Abstract

OBJECTIVES: To evaluate long-term morbidity, mortality, and quality of life (QoL) after pancreaticoduodenectomy (PD) in elderly adults.
DESIGN: Retrospective cohort study.
SETTING: Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel. PARTICIPANTS: One hundred and sixty-eight individuals aged 70 and older who underwent PD between 1995 and 2010. MEASUREMENTS: A prospective pancreatic surgery database was analyzed for postoperative morbidity; mortality; intensive care unit (ICU), hospital, and rehabilitation facility stay; and readmissions after surgery. QoL was assessed using a validated questionnaire completed 3, 6, and 12 months after surgery.
RESULTS: Seventy-two percent of the participants had an American Society of Anesthesiologists score of 3 or greater. There was no intraoperative death. Thirty- and 60-day postoperative mortality rates were 5.9% and 6.5%, respectively. Median ICU stay was 2 days, and median hospital stay was 22 days. Sixty-four participants (37.5%) were discharged to a rehabilitation facility. The first-year readmission rate was 31%. One- and 2-year overall survival rates were 58% and 36%, respectively. Global QoL scores 3 and 12 months after surgery were 68% and 73%, respectively. Scores were lower yet comparable with those of matched individuals undergoing laparoscopic cholecystectomy.
CONCLUSION: Most elderly adults with pancreatic cancer survive longer than 1 year after PD; 36% survive longer than 2 years. These individuals are likely to have acceptable long-term morbidity and overall good QoL, corresponding with their age.
© 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Entities:  

Keywords:  elderly; long-term morbidity; mortality; pancreaticoduodenectomy; quality of life

Mesh:

Year:  2013        PMID: 23865843     DOI: 10.1111/jgs.12360

Source DB:  PubMed          Journal:  J Am Geriatr Soc        ISSN: 0002-8614            Impact factor:   5.562


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