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Surgical Endoscopy

, Volume 33, Issue 7, pp 2142–2151 | Cite as

Surgical outcomes of laparoscopic distal pancreatectomy in elderly and octogenarian patients: a single-center, comparative study

  • Ke Chen
  • Yu Pan
  • Yi-ping Mou
  • Jia-fei Yan
  • Ren-chao Zhang
  • Miao-zun Zhang
  • Jia-yu Zhou
  • Xian-fa Wang
  • Hendi Maher
  • Qi-long ChenEmail author
Article
  • 68 Downloads

Abstract

Background

Although recent reports have suggested the advantages of laparoscopic distal pancreatectomy (LDP), the potential benefits of this approach in elderly patients remain unclear. The aim of this study was to clarify the value of LDP in the elderly, in whom co-morbid diseases were generally more common.

Methods

Seventy elderly patients (≥ 70 years) and 264 non-elderly patients (40–69 years) who underwent LDP, and 48 elderly patients (≥ 70 years) who underwent open distal pancreatectomy (ODP) between May 2005 and May 2018 were studied. Demographics, intraoperative, and postoperative outcomes were compared.

Results

Comorbidity was more common in elderly patients than in non-elderly patients who underwent LDP (57.1 vs. 38.3%, p < 0.01). The intraoperative factors, postoperative complication rate, and length of hospital stay were comparable in these two groups. Elderly patients who underwent LDP had a significantly shorter operative time (185.5 vs. 208.0 min, p = 0.02), less blood loss (191.0 vs. 291.8 mL, p < 0.01), and reduced length of postoperative hospital stay (11.4 vs. 15.1 days, p < 0.01) than elderly patients who had ODP. The overall complication rate tended to be lower in LDP group than that in ODP group (20.0 vs. 33.3%, p = 0.07).

Conclusion

LDP performed on the elderly is safe and feasible, leading to short-term outcomes similar to those of non-elderly patients. LDP could be an alternative to ODP in elderly patients, providing a lower rate of morbidity and favorable postoperative recovery and outcomes.

Keywords

Laparoscopy Pancreatectomy Elderly Adenocarcinoma Morbidity 

Abbreviations

DP

Distal pancreatectomy

LDP

Laparoscopic distal pancreatectomy

ODP

Open distal pancreatectomy

POPF

Postoperative pancreatic fistula

ISGPF

International Study Group on Pancreatic Fistula

PDAC

Pancreatic duct adenocarcinoma

RLN

Retrieved lymph nodes

SD

Standard deviation

BMI

Body mass index

ASA

American society of anesthesiologists

SCA

Serous cystadenoma

MCA

Mucinous cystadenoma

IPMN

Intraductal papillary mucinous neoplasm

SPT

Solid pseudopapillary tumor

NEN

Neuroendocrine neoplasm

CD

Clavien–Dindo classification

Notes

Compliance with ethical standards

Disclosures

Ke Chen, Yu Pan, Yi-ping Mou, Jia-fei Yan, Ren-chao Zhang, Miao-zun Zhang, Jia-yu Zhou, Xian-fa Wang, Hendi Maher, and Qi-long Chen have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ke Chen
    • 1
  • Yu Pan
    • 1
  • Yi-ping Mou
    • 2
  • Jia-fei Yan
    • 1
  • Ren-chao Zhang
    • 2
  • Miao-zun Zhang
    • 3
  • Jia-yu Zhou
    • 4
  • Xian-fa Wang
    • 1
  • Hendi Maher
    • 5
  • Qi-long Chen
    • 1
    Email author
  1. 1.Department of Hepatopancreatobiliary Surgery, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
  2. 2.Department of Gastrointestinal and Pancreatic SurgeryZhejiang Provincial People’s HospitalHangzhouChina
  3. 3.Department of Hepatopancreatobiliary Surgery, Ningbo Medical CenterLihuili HospitalNingboChina
  4. 4.Department of Thoracic Surgery, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhouChina
  5. 5.School of MedicineZhejiang UniversityHangzhouChina

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