Turkish Journal of Geriatrics 2022 , Vol 25, Issue 3
IS THE WHIPPLE PROCEDURE SAFE AND FEASIBLE IN ELDERLY PATIENTS?
Ahmet Cem ESMER1, Deniz TİKİCİ1, Deniz TAZEOĞLU1, Hakan CANBAZ1, Aydemir ÖLMEZ1
1Mersin University, Faculty of Medicine, Department of General Surgery, Mersin, Turkey DOI : 10.31086/tjgeri.2022.302 Introduction: The world population is getting older due to increasing life expectancy. Deciding to perform surgery for pancreatic cancer in elderly patients has been difficult due to high comorbidities and limited survival. This study aimed to compare the results of the Whipple procedure performed in elderly patients with non-elderly patients to demonstrate the safety and feasibility of the Whipple procedure.

Materials and Methods: Patients underwent the Whipple procedure for pancreatic adenocarcinoma between January 2010 and December 2019 were retrospectively analyzed. Patients were classified into two groups as, Group I (<65 years) and Group II (?65 years), and compared.

Results: 178 patients were included, with 97 (54.5%) in group I and 81 (45.5%) in group II. The mean age of the patients was 63.48±12.95 years, while 65.2% were male and 34.8% were female. Gender distribution, preoperative hyperbilirubinemia, The American Society of Anesthesiologists score, and endoscopic retrograde cholangiopancreatography status were found to be statistically similar between the groups. Group II had more comorbid disease (p=0.002), longer hospital stay duration (p<0.001), and more intensive care unit admission (p=0.001). There was no statistical difference between the groups regarding postoperative complications, pancreatic cancer stage, and R0 resection rate. There was no difference between the groups regarding survival (p=0.11).

Conclusion: The Whipple procedure is an operation with a high complication rate regardless of age. The most adverse factor affecting survival is the aggressive nature of the disease rather than older age. Therefore, the Whipple procedure is safe and feasible in elderly patients. Keywords : Aged; Pancreatic Neoplasms; Survival; Pancreaticoduodenectomy