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Safety and feasibility of laparoscopic pancreaticoduodenectomy in octogenarians

Authors
 Ji Su Kim  ;  Munseok Choi  ;  Sung Hyun Kim  ;  Sung Hoon Choi  ;  Chang Moo Kang 
Citation
 ASIAN JOURNAL OF SURGERY, Vol.45(3) : 837-843, 2022-03 
Journal Title
ASIAN JOURNAL OF SURGERY
ISSN
 1015-9584 
Issue Date
2022-03
MeSH
Aged ; Aged, 80 and over ; Feasibility Studies ; Humans ; Laparoscopy* ; Length of Stay ; Octogenarians ; Pancreatic Neoplasms* ; Pancreaticoduodenectomy ; Postoperative Complications / epidemiology ; Postoperative Complications / surgery ; Retrospective Studies
Keywords
Laparoscopy ; Octogenarian ; Pancreaticoduodenectomy ; Periampullary tumor
Abstract
Introduction: With continued technical advances in surgical instruments and growing surgical expertise, many laparoscopic pancreaticoduodenectomies (LPDs) have been safely performed with favorable outcomes, and this approach is being used more frequently. With an increase in the life expectancy, interest in treatments for elderly patients has increased. In this study, we investigated the safety and feasibility of LPD in octogenarians.

Methods: From September 2005 to February 2020, resectable/borderline resectable periampullary tumors (PATs) were diagnosed in 71 octogenarians at Sincheon Severance Hospital and CHA Bundang Medical Center. Patients were divided into two groups: those who underwent surgery (PD, N = 38) and those who did not (NPD, N = 33). The group that underwent surgery was further divided into two groups: those who underwent open PD (OPD, N = 19), and those who underwent LPD (LPD, N = 19). Perioperative outcomes, including long-term survival, were retrospectively compared between these groups.

Results: There was no significant difference in age, sex, comorbidities, diagnosis, and chemo-radiotherapy between the surgery and non-surgery groups. The PD group had a better survival rate than the NPD group (p < 0.05). The baseline characteristics and postoperative outcomes were not significantly different between the OPD and LPD groups. Only three and two patients in the OPD and LPD groups had a biochemical leak (p > 0.999). There was no significant difference in overall survival and disease-free survival between the OPD and LPD groups (p = 0.816, p = 0.446, respectively).

Conclusions: LPD is a good alternative for octogenarians with PAT requiring PD.
Files in This Item:
T202125428.pdf Download
DOI
10.1016/j.asjsur.2021.09.021
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Sung Hyun(김성현) ORCID logo https://orcid.org/0000-0001-7683-9687
Kim, Ji Su(김지수) ORCID logo https://orcid.org/0000-0002-9501-9665
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/187828
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