Safe major abdominal operations: hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients.
Safe major abdominal operations: hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients.
复制标题
安全的腹部大手术：老年患者的肝切除术、胃切除术和胰十二指肠切除术。
DOI：
10.3748/wjg.v10.i13.1995
复制
发表时间：
2004
影响因子：
4.3
通讯作者：
Bin Xu
中科院分区：
文献类型：
--
作者：
Yu;Jun;Bin Xu
目的
评估高龄对肝切除术、胃切除术和胰切除术后结局的影响。
方法
回顾性分析1998年1月至2002年9月间211例肝、胃、胰切除术患者的临床资料。对83例65岁以上患者的临床病理特征和手术结果进行了比较，并与128例65岁以下患者进行了比较。
结果
老年患者术前血清白蛋白、血红蛋白等营养状况差于年轻患者。老年患者的合并症高于年轻患者（48.2% vs 15.6%）。老年患者和年轻患者的围手术期死亡率和并发症发生率无显著差异（分别为2.4% vs 1.6%和22.9% vs 20.3%）。多因素分析显示，胰腺切除术、肝切除术合并2个以上肝段切除术和合并症是术后并发症的独立预测因素，而年龄不是（P=0.3172）。
结论
65岁以上患者行肝、胰、胃切除术，只要围手术期注意，是安全的。
AIM
To evaluate the impact of advanced age on outcome after hepatectomy, gastrectomy and pancreatoduodenectomy.
METHODS
Two hundreds and eleven patients undergone hepatectomy, gastrectomy and pancreatoduodenectomy from January 1998 to September 2002 were analyzed retrospectively. Clinicopathologic features and operative outcome of 83 patients aged 65 years or more were compared with that in 128 younger patients aged less than 65 years.
RESULTS
The nutritional state, such as pre-operation level of serum albumin and hemoglobin in the older patients was poorer than that in the younger patients. The older patients had higher comorbidities than the younger patients (48.2% vs 15.6%). No significant difference was observed in perioperative mortality, and complication rate between the older and younger patients (2.4% vs 1.6% and 22.9% vs 20.3%, respectively). Multivariate analysis demonstrated that pancreatoduodenectomy, hepatectomy with resection of more than 2 segments and comorbidities were independent predictors of postoperative complication, whereas age was not (P=0.3172).
CONCLUSION
It is safe for patients aged 65 years or more to undergo hepatic, pancreatic and gastric resection if great care is taken during perioperative period.