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Hepatobiliary and pancreatic surgery in the elderly: Current status
Ann Hepatobiliary Pancreat Surg 2020 Feb;24(1):1-5
Published online February 29, 2020;  https://doi.org/10.14701/ahbps.2020.24.1.1
Copyright © 2020 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Davide Papis1, Alessio Vagliasindi2, and Pietro Maida1

1General Surgery Unit, Del Mare Hospital, Naples,
2General Surgery Unit, Santa Maria delle Croci Hospital, Ravenna, Italy
Received August 13, 2019; Revised September 14, 2019; Accepted September 16, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Hepato-pancreatico-biliary (HPB) surgery includes major hepatic resection and pancreatic surgery, both procedures are complex and have a potentially high complication rate. The presence of centers of excellence with a high patients volume has lowered the complication and increased the resection rate. Increased life expectancy and improved general health status have increased the number of elderly patients eligible for major surgery. Since old patients have more co-morbidities and decreased life expectancy, the benefit of these procedures need to be critically evaluated in this group. Analysis of the literature related to this argument demonstrated that pancreatoduodenectomy can be performed safely in selected elderly patients (70 years of age or older), with morbidity and mortality rates comparable those observed in younger patients. This aspect was also confirmed by cost analysis studies that reported similar data in both groups. Similar findings are also reported for major hepatic resection in elderly patients with either hepatocellular carcinoma (HCC), Klatskin tumor or gallbladder carcinoma. More studies are needed regarding the subgroup of very elderly patients (80 years or older). Nevertheless, those elderly patients who will benefit from surgery must be adequatelly selected.
Keywords : Liver; Pancreas; Surgery; Elderly

 

February 2020, 24 (1)