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Pancreatic Surgery in the Elderly: a Single Institution's Experience Over Two Decades
Bhaumik Brahmbhatt*1, Frank Lukens1, Abhishek Bhurwal1, Mauricia Buchanan2, Horacio J. Asbun2, John Stauffer2
1Gastroenterology, Mayo Clinic, Jacksonville, FL; 2General Surgery, Mayo Clinic, Jacksonville, FL
BACKGROUND: As the elderly population in the United States rapidly increases, patients of advanced age are more frequently being evaluated for pancreatic pathology requiring surgical intervention. Literature shows varied outcomes with some studies reporting an increase in perioperative complications for elderly patients.
AIM: To compare the outcomes of pancreatic surgery including 90 day morbidity and mortality for patients aged ≥75 to those aged <75 in a single center.
METHODS: Analysis of an institutional database of consecutive 938 pancreatectomies performed between March 1995 and July 2014. 167 pancreatectomies performed in patients ≥75 years of age (elderly) were compared with 771 patients <75 years of age using chi-square and Student's t tests.
RESULTS: Patient demographics and comorbidities are given in Table 1. Elderly patients had significantly more preoperative comorbidities compared with patients less than 75 years of age, based on the American society of Anesthesiologist (ASA) classification.
Intraoperative details and 90-day postoperative outcomes and complications are given in Table 2. There was no statistically significant difference in rates of the following: duration of surgery, type of pancreatectomy, overall complications of surgery including pancreatic fistula, estimated blood loss, post pancreatectomy hemorrhage, wound infections and pulmonary complications and renal insufficiency. Among the elderly, there were a statistically significant increased number of patients with pre-operative cardiac co-morbidity as well as postoperative cardiac complications. However, the latter was significant only for post-operative arrhythmias. There was no statistically significant increase in the number of other complications or in 90 day postoperative mortality.
CONCLUSIONS: Despite increased comorbidities, appropriately selected patients aged ≥75 years do not appear to experience increased postoperative complications or mortality after pancreatectomy compared to younger patients.
 
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