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Surgical palliation of unresectable pancreatic head cancer in elderly patients 被引量:4

Surgical palliation of unresectable pancreatic head cancer in elderly patients
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摘要 AIM: To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer. METHODS: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (Group A). These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass (Group B). In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older (Group C), who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life. RESULTS: Five patients (26.0%) in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death (5.3%) occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree (P = 0.019, P = 0.029, respectively). The median hospital-free survival period and themedian overall survival were also signifi cantly longer in Group A (P = 0.001 and P < 0.001, respectively). CONCLUSION: Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head cancer. AIM: To determine if surgical biliary bypass would provide improved quality of residual life and safe palliation in elderly patients with unresectable pancreatic head cancer. METHODS: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (Group A). These patients were compared with 19 patients under 65 years of age who were managed with surgical biliary bypass (Group B). In addition, the results for group A were compared with those obtained from 17 patients, 65 years of age or older (Group C), who received percutaneous transhepatic biliary drainage to evaluate the quality of residual life. RESULTS: Five patients (26.0%) in Group A had complications, including one intraabdominal abscess, one pulmonary atelectasis, and three wound infections. One death (5.3%) occurred on postoperative day 3. With respect to morbidity, mortality, and postoperative hospitalization, no statistically significant difference was noted between Groups A and B. The number of readmissions and the rate of recurrent jaundice were lower in Group A than in Group C, to a statistically significant degree (P = 0.019, P = 0.029, respectively). The median hospital-free survival period and the median overall survival were also significantly longer in Group A (P = 0.001 and P 〈 0.001, respectively). CONCLUSION: Surgical palliation does not increase the morbidity or mortality rates, but it does increase the survival rate and improve the quality of life in elderly patients with unresectable pancreatic head ca n ce r.
机构地区 Department of Surgery
出处 《World Journal of Gastroenterology》 SCIE CAS CSCD 2009年第8期978-982,共5页 世界胃肠病学杂志(英文版)
关键词 ADENOCARCINOMA ELDERLY Palliative surgery Pancreas neoplasms 晚期胰头癌 老年患者 姑息 胆道引流术 旁路手术 外科 生活质量 无病生存期
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同被引文献38

  • 1Hua, Yun-Peng,Liang, Li-Jian,Peng, Bao-Gang,Li, Shao-Qiang,Huang, Jie-Fu.Pancreatic head carcinoma:clinical analysis of 189 cases[J].Hepatobiliary & Pancreatic Diseases International,2009,8(1):79-84. 被引量:14
  • 2Song C. Kim,Ki B. Song,Yong S. Jung,Young H. Kim,Do H. Park,Sang S. Lee,Dong W. Seo,Sung K. Lee,Myung H. Kim,Kwang M. Park,Young J. Lee.Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience[J]. Surgical Endoscopy . 2013 (1)
  • 3B.Zevin,R.Aggarwal,T. P.Grantcharov.Simulation‐based training and learning curves in laparoscopic Roux‐en‐Y gastric bypass[J]. Br J Surg . 2012 (7)
  • 4Caitriona B. O’Neill,Coral L. Atoria,Eileen M. O’Reilly,Jennifer LaFemina,Martin C. Henman,Elena B. Elkin.Costs and trends in pancreatic cancer treatment[J]. Cancer . 2012 (20)
  • 5CHOON‐KIATHO,J?RGKLEEFF,HELMUTFRIESS,MARKUS W.BüChler.Complications of pancreatic surgery[J]. HPB . 2009 (2)
  • 6Chinnasamy Palanivelu,Kalpesh Jani,Palanisamy Senthilnathan,Ramasamy Parthasarathi,Subbaiah Rajapandian,Madathupalayam Velusamy Madhankumar.Laparoscopic Pancreaticoduodenectomy: Technique and Outcomes[J]. Journal of the American College of Surgeons . 2007 (2)
  • 7Moritz N. Wente,Claudio Bassi,Christos Dervenis,Abe Fingerhut,Dirk J. Gouma,Jakob R. Izbicki,John P. Neoptolemos,Robert T. Padbury,Michael G. Sarr,L. William Traverso,Charles J. Yeo,Markus W. Büchler.Delayed gastric emptying (DGE) after pancreatic surgery: A suggested definition by the International Study Group of Pancreatic Surgery (ISGPS)[J]. Surgery . 2007 (5)
  • 8Roderick M. Quiros,Kimberly M. Brown,John P. Hoffman.Neoadjuvant Therapy in Pancreatic Cancer[J]. Cancer Investigation . 2007 (4)
  • 9Mickael Lesurtel M.D.,Nidal Dehni M.D.,Emmanuel Tiret M.D.,Rolland Parc M.D.,Fran?ois Paye M.D., Ph.D..Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal[J]. Journal of Gastrointestinal Surgery . 2006 (2)
  • 10Keith D. Lillemoe,John L. Cameron,Jeffrey M. Hardacre,Taylor A. Sohn,Patricia K. Sauter,JoAnn Coleman,Henry A. Pitt,Charles J. Yeo.Is Prophylactic Gastrojejunostomy Indicated for Unresectable Periampullary Cancer?: A Prospective Randomized Trial[J]. Annals of Surgery . 1999 (3)

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