Résultats de la duodénopancréatectomie chez les octogénaires: expérience monocentrique et revue de la littérature

Introduction. - Pancreatic and perampullary neoplasms in patients aged 80 or older troublethe surgeons because of the risk of surgical treatment. We have reviewed our experience andliterature's reports of pancreaticoduodenectomy in octogenarians, evaluating early results andlong-term survival in pancreatic cancer group.Methods. - Three hundred and eighty-five patients, who underwent pancreaticoduodenectomyfor neoplasms from 1998 to 2011, were included in the study, and were divided in two groups:group 1, patients younger than 80 years of age, and group 2, patients 80 years of age and older.Operative morbidity, mortality, disease-free and long-term survival were analysed. English lite-rature was systematically searched for pancreatic resection's outcome in octogenarians.Results. - There were 385 pancreaticoduodenectomies: 362 patients were in group 1 and 23patients in group 2. There was no significant difference regarding gender, and pathologic findingsbetween the two groups. Complications' rate (40 vs. 43%), mortality rate (4% vs. 0%), and overallmedian survival for pancreatic cancer patients were not statistically different in the two groups(median 21 vs. 19 months). Literature's review showed 14 reports of pancreatic resection inoctogenarians. Most of the studies (particularly in centres with high-volume pancreatic surgery)showed that outcome after pancreatectomy was not different in octogenarians or in youngerpatients.Conclusion. - Pancreaticoduodenectomy is an acceptable option for elderly patients. Age aloneshould not be considered a contraindication to major pancreatic resection, but a careful preo-perative evaluation and an accurate postoperative management are mandatory.