The Risk Factors Of Pancreaticoduodenectomy In Elderly Patients

OBJECTIVESThe aim of this research was to analysis the efficacy of the502cases fromUnion Hospital Wuhan over past four years. Discuss the risk factors of complication afterpancreaticoduodenectomy in elderly patients. Explore solutions to improve the effect ofpostoperative outcome.METHODSA restrospective analysis of502patients who had underwent pancreaticoduodenectomybecause of the cancer of pancreas, bile duct and duodenal from January2008to December2011in Union Hospital Wuhan was made. The patients are divided into two groups, morethan65years of191patients (group A), and less than65of311patients (group B). Contrastthe patients of complications of group A with group B, figure out the complications ofsignificant difference. With the groupA’s significant differences as outcome variables,through univariate analysis and multivariate analysis to explore the risk factors ofcomplications.RESULTSThe incidence of group A are significant higher in pancreatic fistula, gastric emptyingdelay, lung infection,delirium. The pancreatic fistula, delayed gastric emptying, pulmonaryinfection, delirium of groupA’s independent risk factors: moderate or severe restrictiveventilatory dysfunction, preoperative total bilirubin≥171umol/L, blood loss duringsurgery≥1000ml, albumin level <25g/L, and imbalance of water and electrolyte acid-base. CONCLUSIONThe pancreatic fistula, pulmonary infection, delayed gastric emptying, delirium ofelderly group’s independent risk factors: moderate or severe restrictive ventilatorydysfunction, preoperative total bilirubin≥171umol/L, blood loss during surgery≥1000ml,albumin level <25g/L, and imbalance of water and electrolyte acid-base. According to themain risk factors lead to complications, appropriate perioperative management may reducethe dangerous of senile patients after pancreaticoduodenectomy.