Surgical palliation of unresectable pancreatic head cancer in elderly patients

• Published in: World journal of gastroenterology : WJG 2009-02, Vol.15 (8), p.978-982
• Main Authors: Hwang, Sang Il, Kim, Hyung Ook, Son, Byung Ho, Yoo, Chang Hak, Kim, Hungdai, Shin, Jun Ho
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - mortality; Adenocarcinoma - surgery; Adenocarcinoma - therapy; Aged; Biliopancreatic Diversion; Bilirubin - blood; Brief; Female; Humans; Length of Stay; Male; Middle Aged; Palliative Care - methods; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - surgery; Pancreatic Neoplasms - therapy; Quality of Life; Retrospective Studies; Survival Analysis; Survivors; 旁路手术; 无病生存期; 晚期胰头癌; 生活质量; 老年患者; 胆道引流术
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.15.978

AIM： To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer. METHODS： Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass （Group A）. These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass （Group B）. In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older （Group C）, who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life. RESULTS： Five patients （26.0%） in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death （5.3%） occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree （P = 0.019, P = 0.029, respectively）. The median hospital-free survival period and the median overall survival were also significantly longer in Group A （P = 0.001 and P 〈 0.001, respectively）. CONCLUSION： Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head ca n ce r.