Heeji Shin, MD, Ki Byung Song, MD, PhD, Young-Joo Lee, MD, PhD, Kwang-Min Park, MD, PhD, Song Cheol Kim, MD, PhD, Dae Wook Hwang, MD, PhD, Jae Hoon Lee, MD, PhD, Sang Hyun Shin, MD, PhD. ASAN Medical Center
INTRODUCTION: Despite laparoscopic surgery being a less invasive procedure and widely accepted surgical method worldwide, there is little evidence regarding the safety and benefits of laparoscopic pancreaticoduodenectomy (Lap PD) in elderly patients. To evaluate the feasibility and efficacy of Lap PD in elderly patients, we compared the perioperative outcomes of Lap PD with those of open surgery in elderly patients.
METHODS: A retrospective review of 1430 patients who underwent PD for periampullary tumors in our hospital from January 2014 to December 2016 was performed. Of these, 259 patients were elderly patients (≥70 years of age), 34 patients were in the Lap PD group, 225 were in the Open PD group. One-to-two propensity score matching (34:68) was used to match baseline characteristics between patients with Lap and Open PD.
RESULTS: Laparoscopic PD was accompanied with significantly less postoperative complications (33.8% vs. 11.8%, p-value=0.017) including postoperative pancreatic fistula, less analgesic injections (15.6 vs. 10 times, p-value=0.022), earlier recovery and longer operative time (280 vs. 330 minutes, p-value=0.001) compared with open PD in elderly patients.
CONCLUSION: Lap PD in elderly patients was superior to open surgery, in terms of the perioperative outcomes. It is a feasible treatment option for selected elderly patients with periampullary tumors.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87214
Program Number: S065
Presentation Session: Liver/Pancreas Session
Presentation Type: Podium