Clinical efficacy of laparoscopic pancreaticoduodenectomy in elderly patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GONG Shuai , ZHANG Xiuzhong , ZHANG Pengbo ,  ZHANG Chong , WU Nai , ZHANG Yi , REN Zeqiang

Department of General Surgery, Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu 221002, P. R. China;

Corresponding?author：

ZHANG Chong, Email: zc1604@126.com

Keywords：

elderly patient; pancreaticoduodenectomy; laparoscope; complication

DOI：

10.7507/1007-9424.202006032

Video：

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Objective To explore the feasibility and application value of laparoscopic pancreaticoduodenectomy (LPD) in elderly patients.Methods The clinical data of patients who underwent LPD from August 2016 to July 2019 were retrospectively analyzed. The patients were allocated into the elderly group (≥65 years old) and non-elderly group (<65 years old). The early surgical outcomes and postoperative complications of the two groups were compared.Results In this study, 69 cases of LPD were collected, including 42 cases in the elderly group and 27 cases in the non-elderly group. Compared with the non-elderly group, the proportion of patients complicated comorbidities was higher (P<0.05), albumin level was lower (P<0.05), and American Society of Anesthesiologists classification was higher (P<0.05) in the elderly group. There were no significant differences in the intraoperative conditions, postoperative recovery, and postoperative complications between the two groups (P>0.05), and there were no significant differences in the pathological results of postoperative malignant tumor between the two groups (P>0.05).Conclusions For elderly patients with over 65 years old, LPD is a safe and feasible surgical procedure for clinical practice. Meanwhile, early surgical outcomes are satisfactory, postoperative complications are not increased, and tumor cure effect can be achieved.

Citation： GONG Shuai, ZHANG Xiuzhong, ZHANG Pengbo, ZHANG Chong, WU Nai, ZHANG Yi, REN Zeqiang. Clinical efficacy of laparoscopic pancreaticoduodenectomy in elderly patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(4): 493-499. doi: 10.7507/1007-9424.202006032 Copy

1.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
2.	魯超, 金巍巍, 牟一平, 等. 腹腔鏡胰十二指腸切除術的學習曲線. 外科理論與實踐, 2015, 20(6): 485-489.
3.	張建生, 王文斌, 劉建華, 等. 腹腔鏡胰十二指腸切除術若干關鍵問題. 中國實用外科雜志, 2018, 38(7): 741-746.
4.	Khatkov I, Izrailov R, Tyutyunnik P, et al. One hundred and forty five total laparoscopic pancreatoduodenectomies: A single centre experience. Pancreatology, 2017, 17(6): 936-942.
5.	中華醫學會外科學分會胰腺外科學組, 中國研究型醫院學會胰腺病專業委員會, 中華外科雜志編輯部. 胰腺術后外科常見并發癥診治及預防的專家共識(2017). 中華外科雜志, 2017, 55(5): 328-334.
6.	Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
7.	王在國, 何潤沛, 葉振偉, 等. 80歲以上高齡患者胰十二指腸切除術體會. 中國癌癥防治雜志, 2014, 6(1): 67-69.
8.	王文斌, 閆長青, 呂海濤, 等. 腹腔鏡與開腹胰十二指腸切除術療效分析. 中華肝膽外科雜志, 2017, 23(2): 110-113.
9.	金繼寬, 熊光冰, 朱峰, 等. 腹腔鏡與開腹胰十二指腸切除術治療胰頭癌的近期療效分析. 中華消化外科雜志, 2018, 17(7): 718-723.
10.	Zhang H, Lan X, Peng B, et al. Is total laparoscopic pancreaticoduodenectomy superior to open procedure? A meta-analysis. World J Gastroenterol, 2019, 25(37): 5711-5731.
11.	金巍巍, 徐曉武, 牟一平, 等. 腹腔鏡胰十二指腸切除術單中心233例臨床經驗總結. 中華外科雜志, 2017, 55(5): 354-358.
12.	秦仁義, 馬春陽, 王敏, 等. 腹腔鏡胰十二指腸切除術胰腸吻合方式的選擇. 外科理論與實踐, 2017, 22(2): 106-109.
13.	Torphy RJ, Friedman C, Halpern A, et al. Comparing short-term and oncologic outcomes of minimally invasive versus open pancreaticoduodenectomy across low and high volume centers. Ann Surg, 2019, 270(6): 1147-1155.
14.	蔡合, 蔡云強, 李永彬, 等. 腹腔鏡胰十二指腸切除術在年齡≥70歲患者中的安全性研究. 中華消化外科雜志, 2017, 16(10): 1029-1035.
15.	Sperti C, Moletta L, Pozza G. Pancreatic resection in very elderly patients: A critical analysis of existing evidence. World J Gastrointest Oncol, 2017, 9(1): 30-36.
16.	蔡云強, 夏青紅, 高攀, 等. 加速康復外科在腹腔鏡胰十二指腸切除術中的應用價值. 中華消化外科雜志, 2016, 15(6): 552-556.
17.	Gumbs AA, Rodriguez Rivera AM, Milone L, et al. Laparoscopic pancreatoduodenectomy: a review of 285 published cases. Ann Surg Oncol, 2011, 18(5): 1335-1341.
18.	Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.
19.	Zureikat AH, Moser AJ, Boone BA, et al. 250 robotic pancreatic resections: safety and feasibility. Ann Surg, 2013, 258(4): 554-559.
20.	Croome KP, Farnell MB, Que FG, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg, 2015, 19(1): 189-194.
21.	Stauffer JA, Coppola A, Villacreses D, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc, 2017, 31(5): 2233-2241.
22.	Palanivelu C, Senthilnathan P, Sabnis SC, et al. Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. Br J Surg, 2017, 104(11): 1443-1450.

1. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
2. 魯超, 金巍巍, 牟一平, 等. 腹腔鏡胰十二指腸切除術的學習曲線. 外科理論與實踐, 2015, 20(6): 485-489.
3. 張建生, 王文斌, 劉建華, 等. 腹腔鏡胰十二指腸切除術若干關鍵問題. 中國實用外科雜志, 2018, 38(7): 741-746.
4. Khatkov I, Izrailov R, Tyutyunnik P, et al. One hundred and forty five total laparoscopic pancreatoduodenectomies: A single centre experience. Pancreatology, 2017, 17(6): 936-942.
5. 中華醫學會外科學分會胰腺外科學組, 中國研究型醫院學會胰腺病專業委員會, 中華外科雜志編輯部. 胰腺術后外科常見并發癥診治及預防的專家共識(2017). 中華外科雜志, 2017, 55(5): 328-334.
6. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg, 1935, 102(4): 763-779.
7. 王在國, 何潤沛, 葉振偉, 等. 80歲以上高齡患者胰十二指腸切除術體會. 中國癌癥防治雜志, 2014, 6(1): 67-69.
8. 王文斌, 閆長青, 呂海濤, 等. 腹腔鏡與開腹胰十二指腸切除術療效分析. 中華肝膽外科雜志, 2017, 23(2): 110-113.
9. 金繼寬, 熊光冰, 朱峰, 等. 腹腔鏡與開腹胰十二指腸切除術治療胰頭癌的近期療效分析. 中華消化外科雜志, 2018, 17(7): 718-723.
10. Zhang H, Lan X, Peng B, et al. Is total laparoscopic pancreaticoduodenectomy superior to open procedure? A meta-analysis. World J Gastroenterol, 2019, 25(37): 5711-5731.
11. 金巍巍, 徐曉武, 牟一平, 等. 腹腔鏡胰十二指腸切除術單中心233例臨床經驗總結. 中華外科雜志, 2017, 55(5): 354-358.
12. 秦仁義, 馬春陽, 王敏, 等. 腹腔鏡胰十二指腸切除術胰腸吻合方式的選擇. 外科理論與實踐, 2017, 22(2): 106-109.
13. Torphy RJ, Friedman C, Halpern A, et al. Comparing short-term and oncologic outcomes of minimally invasive versus open pancreaticoduodenectomy across low and high volume centers. Ann Surg, 2019, 270(6): 1147-1155.
14. 蔡合, 蔡云強, 李永彬, 等. 腹腔鏡胰十二指腸切除術在年齡≥70歲患者中的安全性研究. 中華消化外科雜志, 2017, 16(10): 1029-1035.
15. Sperti C, Moletta L, Pozza G. Pancreatic resection in very elderly patients: A critical analysis of existing evidence. World J Gastrointest Oncol, 2017, 9(1): 30-36.
16. 蔡云強, 夏青紅, 高攀, 等. 加速康復外科在腹腔鏡胰十二指腸切除術中的應用價值. 中華消化外科雜志, 2016, 15(6): 552-556.
17. Gumbs AA, Rodriguez Rivera AM, Milone L, et al. Laparoscopic pancreatoduodenectomy: a review of 285 published cases. Ann Surg Oncol, 2011, 18(5): 1335-1341.
18. Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.
19. Zureikat AH, Moser AJ, Boone BA, et al. 250 robotic pancreatic resections: safety and feasibility. Ann Surg, 2013, 258(4): 554-559.
20. Croome KP, Farnell MB, Que FG, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg, 2015, 19(1): 189-194.
21. Stauffer JA, Coppola A, Villacreses D, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc, 2017, 31(5): 2233-2241.
22. Palanivelu C, Senthilnathan P, Sabnis SC, et al. Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. Br J Surg, 2017, 104(11): 1443-1450.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical efficacy of laparoscopic pancreaticoduodenectomy in elderly patients

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