老年患者行胰十二指肠切除术临床特征和并发症分析

Clinical and complications analysis of pancreaticoduodenectomy in elderly people

目的分析行胰十二指肠切除术的老年患者的临床特征和术后并发症的发生情况,探讨老年患者行胰十二指肠切除术的可行性。方法回顾分析2004年至2012年本院94例胰十二指肠切除术患者的临床资料,对年龄≥65岁的老年患者进行分析。结果本研究共纳人老年患者43例,中年患者51例,其中老年组术前合并症发生率(60.47%)显著高于青年组(31.37%)(x^2=7.99,P<0.05)。两组均以经典胰十二指肠切除、Child法重建消化系为主,分别占83.72%和70.59%。老年组病例术后胆瘘等并发症发生率为30.23%,与青年组术后并发症的发生率(23.53%)相比无明显统计学差异(X^2=0.54,P=0.46)。结论高龄不是胰十二指肠切除术的手术禁忌证。老年患者强调充分的术前准备,术后加强监测和管理,早期及时处理合并症。

Objective To analysis the clinical characteristics and postoperative complications situation of elderly patients with pancreaticoduodenectomy （PD） and to discuss the feasibility of PD in elderly patients. Methods 94 patients undergoing PD between 2004 to 2012 were divided into elderly group （ ≥65 ） or middle age group （〈65）, and tbe clinical data were analyzed. Results ：94 patients include 43 elderly patients and 51 middle age patients. The most operation type in both groups was standard PD （83.72% in elderly group and 70. 59% in middle age group）. The incidence of preoperative complication in elderly group （60. 47% ）, including hypertension, diabetes, gallstones, cholangitis, cirrhosis and hyperlipidemia, was significantly higher than that in middle age group （ 31.37%, χ2 = 7.99,P 〈 0. 05 ）. There was no significantly difference in the incidence of postoperative complications between elderly group （30. 23% ） and middle age group （23.53%,χ2 = 0. 54, P = 0.46）. Conclusion ： The incidence of postoperative complica- tions and mortality could be under control through sufficient preoperative preparation, positive treatment of complications and Strengthen postoperative monitoring and management. Age is not absolute operation contraindication.