• Pancreas · Nov 2014

    Review Meta Analysis Comparative Study

    Pancreatic resection in patients 80 years or older: a meta-analysis and systematic review.

    • Riccardo Casadei, Claudio Ricci, Enrico Lazzarini, Giovanni Taffurelli, Marielda D'Ambra, Marianna Mastroroberto, Antonio Maria Morselli-Labate, and Francesco Minni.
    • From the Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy.
    • Pancreas. 2014 Nov 1;43(8):1208-18.

    ObjectiveThe aim of this study was to evaluate the safety of pancreatic resections in patients 80 years or older.MethodsA systematic search of the literature was carried out that compared perioperative outcomes after pancreatic resection in patients 80 years or older with patients younger than 80 years. The primary end points were postoperative mortality and morbidity. The secondary end points were incidence of postoperative pancreatic fistula, delayed gastric emptying, bile leak, pneumonia, postoperative infection, cardiologic complications, reoperation, and length of hospital stay.ResultsNine studies were found to be suitable for the meta-analysis. The postoperative mortality and morbidity were significantly higher in the group 80 years or older (P < 0.00001 and P = 0.003, respectively) except for patients in whom there were no differences in preoperative comorbidities (P = 0.56 and P = 0.36, respectively). Postoperative cardiac complications were significantly more frequent in patients 80 years or older (P < 0.0001), and the length of hospital stay was significantly longer in octogenarian patients (P = 0.008).ConclusionsPatients 80 years or older have an increased incidence of postoperative mortality, morbidity, and cardiac complications and a longer length of hospital stay than do younger patients. Thus, pancreatic resection can be recommended only in a selected group of patients 80 years or older.

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