Table 2.
Baseline characteristics in the elderly patient subgroup
| Variable | Elderly only (n = 338) | Laparoscopic PD (n = 113) | Open PD (n = 225) | P-value |
|---|---|---|---|---|
| Basic demographics | ||||
| Age, years, mean ± SD | 76.4 ± 4.4 | 76.5 ± 4.3 | 76.4 ± 4.5 | 0.816 |
| Gender, n (%) | 0.003 | |||
| Male | 191 (56.5%) | 51 (45.1%) | 140 (62.2%) | |
| Female | 147 (43.5%) | 62 (54.9%) | 85 (37.8%) | |
| BMI, kg/m2, mean ± SD | 26.8 ± 4.4 | 26.9 ± 4.7 | 26.8 ± 4.3 | 0.919 |
| Comorbidities, n (%) | ||||
| Obesity (BMI ≥30 kg/m2) | 73 (21.6%) | 28 (24.8%) | 45 (20.0%) | 0.314 |
| Any alcohol use | 171 (54.1%) | 47 (42.3%) | 124 (60.5%) | 0.002 |
| Current smoker | 29 (8.6%) | 9 (8.0%) | 20 (8.9%) | 0.775 |
| Steroid use within 6 monthsa | 17 (5.0%) | 9 (8.0%) | 8 (3.6%) | 0.080 |
| CADa | 95 (28.1%) | 34 (30.1%) | 61 (27.1%) | 0.566 |
| COPDa | 35 (10.4%) | 15 (13.3%) | 20 (8.9%) | 0.212 |
| Hypertensiona | 232 (68.6%) | 78 (69.0%) | 154 (68.4%) | 0.913 |
| Diabetesa | 102 (30.2%) | 29 (25.7%) | 73 (32.4%) | 0.200 |
| Renal diseasea | 37 (11.0%) | 12 (10.6%) | 25 (11.1%) | 0.891 |
| Liver diseasea | 15 (4.4%) | 6 (5.3%) | 9 (4.0%) | 0.581 |
| History of VTEa | 19 (5.6%) | 6 (5.3%) | 13 (5.8%) | 0.860 |
| Vascular diseasea | 66 (19.5%) | 26 (23.0%) | 40 (17.8%) | 0.2524 |
| Clinical symptoms, n (%) | ||||
| History of cholangitis | 16 (4.7%) | 6 (5.3%) | 10 (4.4%) | 0.724 |
| History of jaundice | 167 (49.4%) | 47 (41.6%) | 120 (53.3%) | 0.042 |
| History of pancreatitis | ||||
| Any | 36 (10.7%) | 15 (13.3%) | 21 (9.3%) | 0.268 |
| Acute | 28 (8.3%) | 15 (13.3%) | 13 (5.8%) | 0.010 |
| Chronic | 8 (2.4%) | 0 (0%) | 8 (3.6%) | |
| Anaemiab | ||||
| Haemoglobin, g/dl, mean ± SD | 12.6 ± 1.6 | 12.8 ± 1.5 | 12.5 ± 1.6 | 0.099 |
| Haemoglobin ≤10.5 g/dl, n (%) | 71 (21.0%) | 21 (18.6%) | 50 (22.2%) | 0.439 |
| Operative characteristics | ||||
| ASA class | ||||
| Class III/IV versus class I/II, n (%) | 241 (71.9%) | 83 (74.1%) | 158 (70.9%) | 0.532 |
| PD versus PPPD, n (%) | 43 (12.7%) | 13 (11.5%) | 30 (13.3%) | 0.634 |
| Vein resection, n (%) | 57 (16.9%) | 18 (15.9%) | 39 (17.3%) | 0.745 |
| Operative drain, n (%) | 272 (80.5%) | 64 (56.6%) | 208 (92.4%) | <0.001 |
| Total operation time, min, mean ± SD | 361.4 ± 97.2 | 364.5 ± 110.6 | 359.8 ± 90.0 | 0.681 |
| EBL, ml, mean ± SD | 690.3 ± 965.0 | 344.7 ± 346.5 | 868.8 ± 1118.2 | <0.001 |
| Diagnostic characteristics | ||||
| Malignant diagnosis, n (%) | 267 (79.0%) | 75 (66.4%) | 192 (85.3%) | <0.001 |
| Diagnosisc, n (%) | <0.001 | |||
| Pancreatic cancer | 174 (51.5%) | 53 (46.9%) | 121 (53.8%) | |
| Cholangiocarcinoma | 19 (5.6%) | 4 (3.5%) | 15 (6.7%) | |
| Duodenal cancer | 13 (3.9%) | 2 (1.8%) | 11 (4.9%) | |
| Ampullary cancer | 42 (12.4%) | 9 (8.0%) | 33 (14.7%) | |
| Renal cell carcinoma | 6 (1.8%) | 0 | 6 (2.7%) | |
| Neuroendocrine tumour | 14 (4.1%) | 6 (5.3%) | 8 (3.6%) | |
| Pancreatitis | 6 (1.8%) | 3 (2.7%) | 3 (1.3%) | |
| Cystic neoplasm | 2 (0.6%) | 0 (0%) | 2 (0.9%) | |
| IPMN | 51 (15.1%) | 29 (25.7%) | 22 (9.8%) | |
| Other | 11 (3.3%) | 7 (6.2%) | 4 (1.8%) | |
| Neoadjuvant therapyd, n (%) | 16 (4.7%) | 5 (4.4%) | 11 (4.9%) | 0.850 |
Percentage values for categorical variables reflect proportions according to the total available data for that variable.
Any steroid use: systemic steroid administration within 6 months of operation. CAD: history of myocardial infarction, percutaneous coronary intervention, or coronary artery bypass graft. COPD: documented medical history supported by radiological and/or functional evaluation. Hypertension: elevated blood pressure requiring medications for adequate control. Diabetes: impaired glycaemic regulation requiring insulin, oral hypoglycaemic agents, and/or dietary modification. Renal disease: impaired renal function based on biochemical evaluation and/or solitary kidney. Liver disease: history of viral hepatitis, steatohepatitis, or cirrhosis. History of VTE: any prior history of deep vein thrombosis and/or pulmonary embolus. Vascular disease: peripheral arterial disease and/or arterial aneurysm with or without repair.
Clinical symptoms documented were based upon initial presentation. Anaemia was defined as a haemoglobin level ≤10.5 g/dl, which represented the 25th percentile of the cohort, for the purposes of risk-adjusted multivariate analyses.
Other: sarcoma, lymphoma, gastrointestinal stromal tumour, adenoma, benign stricture, solid pseudopapillary epithelial neoplasm, etc.
Neoadjuvant therapy: any preoperative chemotherapy, radiation therapy or both.
ASA, American Society of Anesthesiologists; BMI, body mass index; CAD, coronary artery disease; COPD, chronic obstructive pulmonary disease; EBL, estimated blood loss; IPMN, intraductal papillary mucinous neoplasm; PD, pancreatoduodenectomy without pylorus preservation; PPPD, pylorus-preserving pancreatoduodenectomy; SD, standard deviation; VTE, venous thromboembolism.