2017
DOI: 10.1016/j.hpb.2017.01.018
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The outcomes of pancreaticoduodenectomy in patients aged 80 or older: a systematic review and meta-analysis

Abstract: Patients aged 80 years and older have approximately double the risk of 30-day post-operative mortality and 50% increased rate of complications following PD. Careful patient selection is required when offering surgery in this age group.

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Cited by 64 publications
(48 citation statements)
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“…Although a consensus definition is lacking, DGE with persistent need for nasogastric intubation occurs in 20-50% of patients, most often in the elderly, and may worsen the nutritional state and prolong hospitalisation. The exact mechanism is unknown, but likely involves loss or damage of autonomic innervation of the stomach, and may be decreased by special surgical techniques with subtotal stomach preservation and antecolic reconstruction [ 17 , 27 , 28 ].…”
Section: Early Post-pancreatico-duodenectomy Ctmentioning
confidence: 99%
“…Although a consensus definition is lacking, DGE with persistent need for nasogastric intubation occurs in 20-50% of patients, most often in the elderly, and may worsen the nutritional state and prolong hospitalisation. The exact mechanism is unknown, but likely involves loss or damage of autonomic innervation of the stomach, and may be decreased by special surgical techniques with subtotal stomach preservation and antecolic reconstruction [ 17 , 27 , 28 ].…”
Section: Early Post-pancreatico-duodenectomy Ctmentioning
confidence: 99%
“…With advances in surgical techniques and perioperative management, pancreaticoduodenectomy (PD) has become a relatively safe procedure at highvolume centers 1) . Postoperative mortality following PD has been reduced to less than 5% 2) ; however, morbidity remains high, with rates of 30 -50% 3,4) , and is especially high in patients over 80 years of age 5) . Among the most important risk factors for postoperative morbidity is postoperative pancreatic fistula (POPF), which can lead to lifethreating surgical site infections (SSI) such as intraabdominal abscess and/or postoperative hemorrhage due to pseudoaneurysm rupture.…”
Section: Introductionmentioning
confidence: 99%
“…У пациентов в возрасте 80 лет и старше, помимо этого, выше частота осложнений [33]. В другом метаанализе [34] 2017 г. проанализированы результаты ПДР у пациентов в возрасте 80 лет и старше. На основании анализа 18 работ установлено, что 30-дневная летальность, частота осложнений, пневмоний, гастростаза и длительность госпитализации в этой группе пациентов выше.…”
Section: Discussionunclassified
“…Ранее продемонстрировано, что возраст не оказывает влияние на развитие данного осложнения [38]. В некоторых работах [5,34,39,40] показано, что частота послеоперационного гастростаза у пациентов в старшей возрастной группе выше, что, возможно, связано с общими для всех пожилых людей нарушениями моторики желудка. Это не подтверждается другими исследователями [41,42] и нашими результатами.…”
Section: Discussionunclassified