Safety and feasibility of minimally invasive distal pancreatectomy for pancreatic cancer in elderly patients: A retrospective study

Abstract

Introduction: Previous studies have not evaluated the surgical difficulty of minimally invasive distal pancreatectomy for pancreatic cancer in elderly patients. Therefore, we aimed to investigate the effect of elderly age on the perioperative outcomes of minimally invasive distal pancreatectomy, focusing on surgical difficulty.

Methods: This single-center retrospective study included patients who underwent minimally invasive distal pancreatectomy for pancreatic cancer at Kansai Rosai Hospital between September 2012 and December 2023. Perioperative outcomes were investigated between the elderly (>75 years) and non-elderly (≤75 years) groups.

Results: Fifty-six patients were included: 26 and 30 in the elderly and non-elderly groups, respectively. The median operative time was significantly shorter in the elderly group than in the non-elderly group (324 vs. 414 min, p = .022), but other surgical outcomes were not significantly different including oncological factors. The median difficulty score was similar between the elderly and non-elderly groups (6 vs. 7, respectively; p = .699). The incidences of postoperative complications and pancreatic fistulas were not significantly different in the elderly and non-elderly groups (23% vs. 43%, p = .159, and 19% vs. 36%, p = .236, respectively), even though analyzed in subgroups with low-to-intermediate or high difficulty score.

Conclusions: The safety and feasibility of minimally invasive distal pancreatectomy for pancreatic cancer were not significantly different between elderly and non-elderly patients, even when surgical difficulty was considered. This surgical procedure can be safe and feasible for elderly patients.

Keywords: elderly; minimally invasive distal pancreatectomy; pancreatic cancer.