高龄患者胰十二指肠切除术的可行性

Clinical assessment of feasibility of pancreaticoduodenectomy in elderly patients

目的:探讨高龄患者行胰十二指肠切除术的可行性.方法:回顾性分析2008-02/2014-02于安徽医科大学附属安徽省立医院行胰十二指肠切除术的临床资料,对于年龄≥65岁的高龄患者进行分析.结果:共纳入高龄组患者68例,低龄组患者201例,两组间术后并发症发生率及围手术期死亡率差异无统计学意义(P>0.05),高龄组患者术后胆瘘、出血、腹腔感染、胃排空障碍、肠梗阻的发生率较低龄组高,差异有统计学意义(P<0.05).结论:高龄不是胰十二指肠切除术的手术禁忌证,加强围手术期诊断和处理和胰腺专业组手术是胰十二指肠切除术手术安全性和规范性的保证,对高龄患者强调术前或术中病理诊断,术后应积极早期干预和处理相关并发症.

AIM： To assess the feasibility of pancreaticoduodenectomy in elderly patients. METHODS： Patients who underwent pancreaticoduodenectomy at our hospital from February 2008 to February 2014, including those aged over 65 years, were analyzed retrospectively. RESULTS： There were 68 patients in the old age group and 201 patients in the young age group. There were no significance differences between the old and young groups in postoperative complications or mortality rate（P 0.05）. There were significant differences in the rates of postoperative biliary fistula, hemorrhage, abdominal infection, gastric emptying, and intestinal obstruction between the two groups（P 0.05）. CONCLUSION： Pancreaticoduodenectomy can be performed in aged people. Intensive perioperative care and excellent operative techniques of operators are important for operative security and standardization. Early evaluation and intervention and timely treatment should be done after pancreaticoduodenectomy.