Pancreatic or liver resection for XXXX is safe and effective for the elderly.

@entity1 @entity5 @entity14
BACKGROUND: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly @entity1 , and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes. METHODS: Five hundred seventy-seven liver resections (July 1985-July 1994) performed for metastatic @entity14 and 488 pancreatic resections (October 1983-July 1994) performed for pancreatic @entity5 were identified in departmental data bases. Outcomes of @entity1 younger than age 70 years were compared with those of @entity1 age 70 years or older. RESULTS: Liver resection for 128 @entity1 age 70 years or older resulted in a 4% perioperative mortality rate and a 42% complication rate. Median hospital stay was 13 days, and 8% of the @entity1 required admission to the intensive care unit (ICU). Median survival was 40 months, and the 5-year survival rate was 35%. No differences were found between results for the elderly and those for younger @entity1 who had undergone liver resection, except for a minimally shorter hospital stay for the younger @entity1 (median, 12 days vs. 13 days; p = 0.003). Pancreatic resection for 138 elderly @entity1 resulted in a mortality rate of 6% and a complication rate of 45%. Median stay was 20 days, and 19% of the @entity1 required ICU admission, results identical to those for the younger cohort. Long-term survival was poorer for the elderly @entity1 , with a 5-year survival rate of 21% compared with 29% for the younger cohort (p = 0.03). CONCLUSIONS: Major liver or pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronological age alone is not a contraindication to liver or pancreatic resection for @entity5 .
