Age is not a contraindication to pancreaticoduodenectomy

The incidence of pancreatic cancer has increased threefold over the last 40 years with the greatest rate of growth occurring in the elderly. In the pa st it was suggested that elderly patients tolerated pancreaticoduodenectomy less well than younger patients with higher mortality rates. This single-i nstitution experience examines the question of whether age is a significant factor in relation to morbidity and mortality in patients undergoing pancr eaticoduodenectomy. Between 1994 and 1999 outcomes of 122 patients who unde rwent pancreaticoduodenectomy were reviewed. There were 48 patients 70 year s of age and older and 74 patients less than 70 years of age. Both groups w ere compared with respect to preoperative clinical prognostic determinates and perioperative factors affecting morbidity and mortality. There was no s ignificant difference between the two groups comparing their comorbidities, use of preoperative antibiotics, intraoperative blood loss, or length of h ospital stay (11.9 and 10.8 days respectively). The two groups were also si milar with regard to pathologic diagnosis with pancreatic adenocarcinoma be ing the most frequently encountered neoplasm. There was one death in the le ss-than-70-year-old group and none in the older group. No significant diffe rence in the rate of complications was appreciated. These data demonstrate that pancreaticoduodenectomy can be performed safely in patients 70 years o f age and older with morbidity and mortality rates similar to those of youn ger individuals.