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目的:分析80岁以上病人的胰十二指肠切除术(pancreaticoduodenectomy,PD)的可行性与结果。方法:回顾性分析16例行PD的80岁以上病人资料并与同期80岁以下病人对比。结果:80岁以上组7例病人发生术后并发症(43.8%),腹腔感染和胃排空延迟各2例(12.5%),肺部感染4例(25.0%),心功能不全、腹腔出血、切口感染和泌尿系感染各1例(6.3%)。术后胰瘘4例(25.0%),A级1例,B级2例,C级1例。术后死亡1例(6.3%),原因为胰瘘并发腹腔感染、腹腔出血、肺部感染引起的多脏器功能衰竭,对比80岁以下病人术后死亡率及术后并发症发生率无统计学差异。结论:80岁以上高龄病人不是手术禁忌,该手术安全可行。专业的手术团队,合理评估病人术前情况,围手术期正确处理是降低术后死亡率和并发症发生率的有效措施。
Objective: To analyze the feasibility and result of pancreaticoduodenectomy (PD) in patients over 80 years of age. Methods: Data of 16 patients with PD over 80 years old were retrospectively analyzed and compared with those under 80 years of age. Results: Postoperative complications occurred in 7 patients over 80 years old (43.8%), delayed abdominal infection and delayed gastric emptying (12.5%), pulmonary infection in 4 patients (25.0%), cardiac insufficiency and intraperitoneal bleeding , Incision infection and urinary tract infection in 1 case (6.3%). Postoperative pancreatic fistula in 4 cases (25.0%), A grade in 1 case, B grade in 2 cases, C grade in 1 case. 1 case died of postoperative death (6.3%). The reason was multiple organ failure caused by pancreatic fistula complicated by abdominal infection, celiac hemorrhage and pulmonary infection. Comparing the postoperative mortality rate and postoperative complication rate in patients under 80 years old Differences Conclusion: Aged over 80 years old is not a taboo surgery, the operation is safe and feasible. Professional surgical team, a reasonable assessment of the patient’s preoperative situation, the correct perioperative management is to reduce postoperative mortality and the incidence of complications is an effective measure.