ArticleMedical science monitor : international medical journal of experimental and clinical research2023
Comparative Analysis of Laparoscopic Pancreatoduodenectomy in Elderly Patients: Safety, Efficacy, and Cost Evaluation.
Article in Medical science monitor : international medical journal of experimental and clinical research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND The use of laparoscopic pancreatoduodenectomy in elderly patients has sparked debate due to concerns about its safety. This study evaluates its safety and efficacy for elderly patients. MATERIAL AND METHODS We retrospectively analyzed data from 250 patients who underwent pancreatoduodenectomy between January 2015 and April 2022. Group A consisted of 100 non-elderly patients (under 70) who had laparoscopic procedures; Group B had 60 elderly patients (70 and above) with laparoscopic surgeries; and Group C included 90 elderly patients with open surgeries. Clinical outcomes were then compared across the groups. RESULTS Elderly patients undergoing laparoscopic pancreatoduodenectomy experienced a higher conversion rate (35% vs 19%), increased ICU admissions post-operation (45% vs 23%), a prolonged ICU stay, greater hospital expenses (¥118,782.48 vs ¥106,698.38), and a lower post-operative adjuvant therapy rate (31.91% vs 69.23%). However, they had fewer B-C pancreatic fistulas (5% vs 24%). Compared to open surgery in elderly patients, laparoscopic procedure showed benefits such as reduced blood loss (median of 200 ml) and fewer wound infections (3.33% vs 17.78%). On the downside, laparoscopy had a longer operation time (462.5 minutes vs 315 minutes), took longer before patients could resume oral intake (median of 5.5 days vs 5 days), and incurred higher hospitalization costs (¥118,782.48 vs ¥111,541.60). CONCLUSIONS While laparoscopic pancreatoduodenectomy in elderly patients may not match the outcomes seen in younger patients, it doesn't possess marked drawbacks when compared to open surgery. It is a safe and viable option for the elderly.
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