Contrastive Study on Different Palliation for Elderly Patients with Unresectable Pancreatic Head Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Xiaozhong , ZHAO Shaoyong , LUO Hong , WANG Changsong , HUANG Bin , ZHU Yong , GONG Guang , ZHOU Wenhao , TAO Youjiang.

Department of Hepatopancreatobiliary Surgery, The Second People’s Hospital of Yibin City, Yibin 644000, Sichuan Province, China;

Corresponding author：

Keywords：

Carcinoma; Elderly patient; Palliative surgery; Pancreatic head cancer; Quality of life

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To determine the safety and efficacy of surgical biliary bypass on the elderly patients with unresectable pancreatic head cancer.
Methods The clinical data of 55 cases with unresectable pancreatic head cancer treated with palliation methods from July 2002 to June 2009 in our hospital were retrospectively analyzed. The patients were divided into three groups according to different age and therapeutic program: Nineteen patients, 65 years of age or older, were managed with surgical biliary bypass (group A), 19 patients under 65 years of age were treated by surgical biliary bypass (group B) and 17 patients with the age of 65 years or older received percutaneous transhepatic biliary drainage (group C). Then the therapeutic results were compared.
Results With respect to the postoperative level of serum bilirubin, the incidence of early complications, postoperative hospitalization and mean survival time, no statistically significant difference was found between group A and B (P gt;0.05). There was one case of recurrent jaundice and one case of gastric output obstruction in group B, while no one suffered postoperative complication in group A, and the difference was statistically significant (P lt;0.01). Compared with group A, the postoperative level of serum bilirubin, the number of patient readmitted, the rate of recurrent jaundice and gastric output obstruction were higher in group C (P lt;0.05 or P lt;0.01). The mean postoperative hospitalization and overall survival time were significantly shorter in group C than group A (P lt;0.05 or P lt;0.01, respectively).
Conclusion Surgical palliation does not increase the morbidity rate, but it does improve the quality of life in elderly patients with unresectable pancreatic head cancer.

Citation： JIANG Xiaozhong,ZHAO Shaoyong,LUO Hong,WANG Changsong,HUANG Bin,ZHU Yong,GONG Guang,ZHOU Wenhao,TAO Youjiang.. Contrastive Study on Different Palliation for Elderly Patients with Unresectable Pancreatic Head Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(8): 837-840. doi: Copy

1.	Casadei R, Zanini N, MorselliLabate AM, et al. Prognostic factors in periampullary and pancreatic tumor resection in elderly patients [J]. World J Surg, 2006; 30(11): 19922003.
2.	Singh SM, Longmire WP Jr, Reber HA. Surgical palliation for pancreatic cancer. The UCLA experience [J]. Ann Surg, 1990; 212(2): 132139.
3.	Gouma DJ, van Geenen R, van Gulik T, et al. Surgical palliative treatment in biliopancreatic malignancy [J]. Ann Oncol, 1999; 10 Suppl 4: 269272.
4.	倪泉兴, 杨峰. 规范诊治，努力提高胰腺癌的远期生存率 [J]. 中国普外基础与临床杂志, 2006; 13(5): 493495.
5.	Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008 [J]. CA Cancer J Clin, 2008; 58(2): 7196.
6.	孙备, 陈华. 胰腺癌外科治疗的现状与展望 [J]. 中国普外基础与临床杂志, 2008; 15(8): 547549.
7.	Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies [J]. Ann Surg, 2006; 244(1): 1015.
8.	Richter A, Niedergethmann M, Sturm JW, et al. Longterm results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25year experience [J]. World J Surg, 2003; 27(3): 324329.
9.	CarpelanHolmstrm M, Nordling S, Pukkala E, et al. Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study reevaluating the data of the Finnish Cancer Registry [J]. Gut, 2005; 54(3): 385387.
10.	Winter JM, Cameron JL, Campbell KA, et al. 1 423 pancreaticoduodenectomies for pancreatic cancer: A singleinstitution experience [J]. J Gastrointest Surg, 2006; 10(9): 11991211.
11.	Loos M, Kleeff J, Friess H, et al. Surgical treatment of pancreatic cancer [J]. Ann N Y Acad Sci, 2008; 1138: 169180.
12.	赵玉沛, 张太平. 重视交界性可切除胰腺癌的处理 [J]. 中国普外基础与临床杂志, 2009; 16(8): 597600.
13.	Petrowsky H, Clavien PA. Should we deny surgery for malignant hepatopancreaticobiliary tumors to elderly patients? [J]. World J Surg, 2005; 29(9): 10931100.
14.	Urbach DR, Bell CM, Swanstrom LL, et al. Cohort study of surgical bypass to the gallbladder or bile duct for the palliation of jaundice due to pancreatic cancer [J]. Ann Surg, 2003; 237(1): 8693.
15.	Taylor MC, McLeod RS, Langer B. Biliary stenting versus bypass surgery for the palliation of malignant distal bile duct obstruction: a metaanalysis [J]. Liver Transpl, 2000; 6(3): 302308.
16.	Nuzzo G, Clemente G, Greco F, et al. Is the chronologic age a contraindication for surgical palliation of unresectable periampullary neoplasms? [J]. J Surg Oncol, 2004; 88(4): 206209.
17.	Lesurtel M, Dehni N, Tiret E, et al. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal [J]. J Gastrointest Surg, 2006; 10(2): 286291.

1. Casadei R, Zanini N, MorselliLabate AM, et al. Prognostic factors in periampullary and pancreatic tumor resection in elderly patients [J]. World J Surg, 2006; 30(11): 19922003.
2. Singh SM, Longmire WP Jr, Reber HA. Surgical palliation for pancreatic cancer. The UCLA experience [J]. Ann Surg, 1990; 212(2): 132139.
3. Gouma DJ, van Geenen R, van Gulik T, et al. Surgical palliative treatment in biliopancreatic malignancy [J]. Ann Oncol, 1999; 10 Suppl 4: 269272.
4. 倪泉兴, 杨峰. 规范诊治，努力提高胰腺癌的远期生存率 [J]. 中国普外基础与临床杂志, 2006; 13(5): 493495.
5. Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2008 [J]. CA Cancer J Clin, 2008; 58(2): 7196.
6. 孙备, 陈华. 胰腺癌外科治疗的现状与展望 [J]. 中国普外基础与临床杂志, 2008; 15(8): 547549.
7. Cameron JL, Riall TS, Coleman J, et al. One thousand consecutive pancreaticoduodenectomies [J]. Ann Surg, 2006; 244(1): 1015.
8. Richter A, Niedergethmann M, Sturm JW, et al. Longterm results of partial pancreaticoduodenectomy for ductal adenocarcinoma of the pancreatic head: 25year experience [J]. World J Surg, 2003; 27(3): 324329.
9. CarpelanHolmstrm M, Nordling S, Pukkala E, et al. Does anyone survive pancreatic ductal adenocarcinoma? A nationwide study reevaluating the data of the Finnish Cancer Registry [J]. Gut, 2005; 54(3): 385387.
10. Winter JM, Cameron JL, Campbell KA, et al. 1 423 pancreaticoduodenectomies for pancreatic cancer: A singleinstitution experience [J]. J Gastrointest Surg, 2006; 10(9): 11991211.
11. Loos M, Kleeff J, Friess H, et al. Surgical treatment of pancreatic cancer [J]. Ann N Y Acad Sci, 2008; 1138: 169180.
12. 赵玉沛, 张太平. 重视交界性可切除胰腺癌的处理 [J]. 中国普外基础与临床杂志, 2009; 16(8): 597600.
13. Petrowsky H, Clavien PA. Should we deny surgery for malignant hepatopancreaticobiliary tumors to elderly patients? [J]. World J Surg, 2005; 29(9): 10931100.
14. Urbach DR, Bell CM, Swanstrom LL, et al. Cohort study of surgical bypass to the gallbladder or bile duct for the palliation of jaundice due to pancreatic cancer [J]. Ann Surg, 2003; 237(1): 8693.
15. Taylor MC, McLeod RS, Langer B. Biliary stenting versus bypass surgery for the palliation of malignant distal bile duct obstruction: a metaanalysis [J]. Liver Transpl, 2000; 6(3): 302308.
16. Nuzzo G, Clemente G, Greco F, et al. Is the chronologic age a contraindication for surgical palliation of unresectable periampullary neoplasms? [J]. J Surg Oncol, 2004; 88(4): 206209.
17. Lesurtel M, Dehni N, Tiret E, et al. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal [J]. J Gastrointest Surg, 2006; 10(2): 286291.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Contrastive Study on Different Palliation for Elderly Patients with Unresectable Pancreatic Head Cancer

Abstract Full text Figures/Tables Video References Cited by

Format

Content