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The following is a summary of “Pancreaticoduodenectomy for octogenarians under postoperative rehabilitation enhanced ERAS protocol,” published in the November 2024 issue of Surgery by Iwanaga et al.      

Pancreaticoduodenectomy (PD) is the standard treatment for pancreatic or periampullary cancer, but octogenarians often experience poor postoperative outcomes due to comorbidities and impaired functional status.  

Researchers conducted a retrospective study to compare postoperative outcomes in octogenarians vs. non-octogenarians after PD.  

They included patients who underwent PD (January 2019 and December 2022) at 2 institutions. All patients followed the enhanced recovery after surgery (ERAS) protocol, with additional perioperative rehabilitation for elderly patients, those with muscle mass loss or frailty. Postoperative short-term outcomes were compared between octogenarians and non-octogenarians.  

The results showed 251 patients, 44 octogenarians (17.5%). Octogenarians had more comorbidities (78.9% vs. 55.1%, P=0.049), sarcopenia (31.8% vs. 16.4%, P=0.018), and impaired nutritional status compared to non-octogenarians. Postoperative rehabilitation was received more frequently (86.4% vs. 44.0%, P<0.001). However, under the rehabilitation-enhanced ERAS protocol, and no significant differences in postoperative major complication rates (25.0% vs. 24.6%, P=0.960), length of hospital stay (LOS) (P=0.435), or length of functional recovery (LOFR) (P=0.110). Multivariate analysis showed age ≥80 was not a major complication risk.  

They concluded that octogenarians’ postoperative outcomes, including major complication rates, LOS, and LOFR, were comparable to non-octogenarians when managed under the rehabilitation-enhanced ERAS protocol.  

Source: bmcsurg.biomedcentral.com/articles/10.1186/s12893-024-02656-0