Incidence rates of post-pancreatectomy complications are similar between octogenarians and non-octogenarians and decrease after minimally invasive pancreatic surgery : a retrospective cohort study.

Abstract

Background: This study investigated the incidence of postoperative complications following pancreatectomy in octogenarians.

Methods: This study included 291 patients who underwent pancreatic surgery (pancreatoduodenectomy [PD] or distal pancreatectomy [DP]) between 2019 and 2024 in a Japanese University Hospital. Perioperative outcomes were compared between octogenarians and non-octogenarians. The primary outcomes included the risk factors (including age) and incidence rates for postoperative complications. In addition, 1:3 propensity score matching (PSM) was conducted with standardized patient and perioperative factors, and the incidence of postoperative complications was compared. Finally, the clinical characteristics of octogenarians and non-octogenarians in open surgery and minimally invasive pancreatic surgery (MIPS) were compared.

Results: The median age was 82.0 and 71.0 years for octogenarians (n = 33) and non-octogenarians (n = 258). We found that a high body mass index (BMI) value, PD, laparotomy, high intraoperative blood loss (IBL) (≥ 320mL), and long operative times were associated with the incidence of postoperative complications in univariate analysis, although patient age (octogenarians) was not significantly correlated. PSM showed that the incidence of postoperative complications was similar between octogenarians and non-octogenarians. MIPS led to similar or lower postoperative complication rates in octogenarians compared with non-octogenarians, and both rates were notably lower than those in laparotomy.

Conclusion: Although this study was retrospective, single-center, and with small number of octogenarians, the incidence of postoperative complications after pancreatectomy might not be higher in octogenarians than in non-octogenarians, and it could be reduced with MIPS.