Abstract
Laparoscopic distal pancreatectomy (LDP) appears to be safe and effective as open distal pancreatectomy (ODP) for benign or borderline malignant lesion. However, studies comparing LDP with ODP in elderly patients are limited. The purpose of this study is to compare the clinical outcomes of these two several approaches in elderly patients. A retrospective analysis was carried out by comparing laparoscopic (n=7) and open (n=15) distal pancreatectomy in elderly patients performed at the University of Naples "Federico II" and University of Perugia between January 2012 and December 2015. Demographic data, operative and postoperative outcomes were analyzed. Demographic and tumor characteristics of laparoscopic and ODP were similar. There were also no significant differences in operating room time. Patients undergoing LDP had lower blood loss, first flatus time, diet start time and postoperative hospital stay. There were no significant differences in complication rates or 90-day mortality. LDP is safe and feasible as ODP in selected elderly patients.
Highlights
The elderly population has increased in many countries, and the number of patients older than 70 years of age with resectable pancreatic neoplastic lesion is predicted to rise in the future because of improved surgical techniques and medical management [1, 2]
Two patients (28.6%) developed pancreatic fistula according to the definition of ISGPF, and all patients were recovered with conservative management
A lot of these neoplasms can maybe useful treated using revolutionary approaches such as cell-based therapy or targeting therapies as demonstrated in oncologic [14,15,16,17,18,19] and non-oncologic diseases in aging patients [20, 21]. In this comparative study of clinical outcomes for Laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP), we demonstrated that LDP is a feasible, safe and efficient approach for benign or premalignant pancreatic neoplasms for elderly patients
Summary
The elderly population has increased in many countries, and the number of patients older than 70 years of age with resectable pancreatic neoplastic lesion is predicted to rise in the future because of improved surgical techniques and medical management [1, 2]. Invasive surgery has proved to be safe and effective and has largely replaced open surgery in many procedures Despite this trend, laparoscopic pancreatic surgery has been slow to gain acceptance, but nowadays the laparoscopic technique is becoming increasingly popular among surgeons to perform distal pancreatectomy. A comparison between open surgery and laparoscopic distal pancreatectomy (LDP) confirms advantages commonly ascribed to minimal access surgery such as reduced postoperative pain, faster recovery and fewer wound-related and general morbidity [3, 4]. These outcomes are poorly defined in elderly population and the decision to perform this surgical procedure in an elderly patient can be difficult.
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