关键词: 胰十二指肠切除术, 术前合并症, 术后并发症, 可行性

Abstract: Objective To investigate the feasibility of pancreaticoduodenectomy in elderly patients over 80 years old. Methods A retrospective analysis of 58 patients with pancreaticoduodenectomy performed in Songjiang Hospital Affiliated to Shanghai Jiaotong University School of Medicine from March 2017 to October 2020.Taking 80 years old as the classification standard,28 people aged 80 and above belong to the senior group,and 30 people aged 80 and below belong to the non-elderly group.The preoperative complications,surgery-related conditions and postoperative complications were compared between the two groups. Results The preoperative comorbidities of the two groups were compared.There were 13 cases of hypertension,7 cases of heart disease,9 cases of diabetes mellitus and 16 cases of hypoalbuminemia in the elderly group,and 7 cases,4 cases,3 cases and 7 cases in the non-senior age group,respectively.The difference was statistically significant(P<0.05).Comparison of operation-related indicators between the two groups,the operation time in the elderly group was(172.4±33.2) minutes,and the intraoperative blood loss was(160.0±84.4) ml,while the non-elderly group was(160.6±35.8) minutes and(156.6±84.8) ml,respectively.There was no significant difference between groups(P>0.05).The postoperative hospital stay days in the elderly group were(22.6±9.0) days and in the non-elderly group(18.9±2.8) days,there was a statistically significant difference between the two groups(P<0.05).The postoperative complications,including pancreatic fistula,bile leakage,intra-abdominal infection,delayed gastric emptying and intra-abdominal hemorrhage,showed no significant difference between the two groups(P>0.05).In the comparison of prognostic indicators,there was 1 case of severe pancreatic fistula-induced hemorrhage death in the elderly group,and no death in the non-elderly group,and the difference was not statistically significant(P>0.05).Conclusion Pancreaticoduodenectomy in elderly patients requires adequate preoperative preparation,meticulous intraoperative operation,and effective postoperative management to prevent complications.Even for elderly patients over 80 years old,the operation is safe and feasible.

Key words: pancreatoduodenectomy, preoperative complications, postoperative complications, feasibility