Safe major abdominal operations: Hepatectomy, gastrectomy and pancreatoduodenectomy in elder patients

Table 1 Comparison of clinicopathologic features between the two age groups

Clinicopathologic	Younger group	Older group	P value
Features	(< 65 yr)	(≥ 65 yr)
Age (median)	52	69
Gender (n)			0.21421
Male	87	63
Female	41	20
Diagnosis (n)			0.11052
Liver
Hepatic carcinoma	45	31
Others	3	7
Stomach
Gastric carcinoma	37	30
Others	2	1
Pancrea
Pancreatic carcinoma	15	4
Periampullary carcinoma	23	8
Others	3	2
Serum albumin	3.84 ± 0.46	3.65 ± 0.50	0.00453
(mean ± SD, g/dL)
Hemoglobin	12.05 ± 2.39	11.16 ± 2.33	0.00823
(mean ± SD, g/dL)
Stage of primary cancer (n)			0.56581
I	18	12
II	32	13
III	53	34
IV	17	13
Comorbidity	15.6% (20/128)	48.2% (40/83)	< 0.00011

¹Chi-squere test;

²Fisher’s exact test;

³Student’s t test.

Table 2 Comparison of therapeutic characteristics between the two age groups

Therapeutic characteristics	Younger group (< 65 yr)	Older group (≥ 65 yr)	P value
Operative procedures			0.17081
Hepatectomy ≤ 2 segments	26	23
Hepatectomy > 2 segments	22	15
Gastrectomy-total/proximal	13	11
Gastrectomy-distal	26	20
Pancreatoduodenectomy	41	14
Operative blood loss (median, mL)	500 (100-20000)	500 (50-3500)	0.64803
Operative blood transfusion (median, units)	2 (0-36)	2 (0-13)	0.33953
Rate of complications	20.3% (26/128)	22.9% (19/83)	0.65501
Reoperative rate	2.3% (3/128)	2.4 % (2/83)	1.00002
Perioperative mortality (within 30 d)	1.6% (2/128)	2.4 (2/83)	0.64702
Hospital length of stay (median, d)	21 (4-128)	24 (8-147)	0.02414

¹Chi-squere test;

²Fisher’s exact test;

³Mann-Whitney non-parametric test;

⁴Kaplan-Meier method.

Table 3 Multivariate analysis of factors influencing major post-operative complications

Variables	Odds ratio	95% confidence interval	P value
Pancreatoduodenectomy	3.7736	1.7699-8.0145	0.0006
Hepatectomy > 2 segments	1.0858	1.0060-1.1834	0.0334
Comorbidity	3.2787	1.5361-6.9930	0.0021
Age (as continuous variable)	1.0173	0.9833-1.0537	0.3172

Logistic regression analysis showed pancreatoduodenectomy and hepatectomy with resection of more than 2 segments and comorbidities were independent factors for complications, whereas age was not.