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BACKGROUND: This study compares outcomes of elderly patients (80 years old or greater) undergoing pancreatic resection to a control group of younger patients.METHODS: This is a retrospective study of all patients undergoing pancreatic resection for a neoplasm at our institution between January 2004 and December 2010. RESULTS: One hundred fifty patients underwent pancreatic resections for a neoplasm during the study period. Twenty nine patients were in the octogenarian group; 24 of these patients had an operation for an adenocarcinoma. A group of 31 patients (<80 years old) were included as a comparison group. The groups were evenly matched for type of operation, duration of operation and estimated blood loss. Table 1 shows demographic data for the two groups. Final pathology was comparable. Three patients had positive margins in the elderly population (12.5%) versus 5 in the younger population (16%). Eight patients were node positive in the elderly population compared with nine patients in the younger population. Median tumor size was comparable at 3cm in each group. Post-operatively, elderly patients had a statistically significant increase in length of stay compared to controls (13 versus 8 days, p< 0.02). Length of intensive care stay was not significantly different between the two groups. Two patients died within thirty days in the elderly group compared with no deaths in the control population. Major morbidity in the elderly population was 45% compared with 32% in the younger population. At time of discharge, 15 elderly patients (62.5%) required rehabilitation stays compared with 6 patients (19%) in the control group (p<0.0005). Further, in terms of post-operative chemotherapy, 8 elderly patients underwent chemotherapy (33%) compared with 24 of the control group (77%) (p<0.004). Six elderly patients underwent post-operative radiation compared with 23 patients in the control group (p<0.0009). Most elderly patients did not complete post-operative chemotherapy or radiation therapy regimens.CONCLUSIONS: Elderly patients tolerate major pancreatic resection for adenocarcinoma; however, major morbidity and mortality are higher. The majority of elderly patients require rehabilitation after discharge which may hinder their overall quality of life. Elderly patients should be counseled regarding outcomes prior to pancreatic resection. More studies are needed to further stratify elderly patient’s risk from pancreatectomy.

	Eldely	Control
Total	24	31
Men	8	18
BMI,average	24	31
Median Time to OR (days)	29	20
Procedure
Whipple	20	22
Left pancreatectomy	3	7
Total pancreatectomy	1	2
Average EBL	400	350