ORIGINAL ARTICLE Do not Deny Pancreatic Resection to Elderly Patients Roberto Ballarin & Mario Spaggiari & Fabrizio Di Benedetto & Roberto Montalti & Michele Masetti & Nicola De Ruvo & Antonio Romano & Gian Piero Guerrini & Maria Grazia De Blasiis & Giorgio Enrico Gerunda Received: 20 March 2008 / Accepted: 25 June 2008 / Published online: 11 September 2008 # 2008 The Society for Surgery of the Alimentary Tract Abstract Introduction Radical resection is the only potential cure for pancreatic malignancies and a useful treatment for other benign diseases, such as pancreatitis. Over the last two decades, medical and surgical improvements have drastically changed the postoperative outcome of elderly patients undergoing pancreatic resection, and appropriate treatment for elderly potential candidates for pancreatic resection has become an important issue. Materials and Methods Ninety-eight consecutive patients undergoing radical pancreatic resection between 2003 and 2006 at the Surgery Unit of the University of Modena, Italy, were considered and divided into two age groups, i.e., over 75-year- olds (group 1, 23 patients) and under 75-year-olds (group 2, 75 patients). The two groups were compared as regards demographic features, American Society of Anesthesiologists scores, comorbidities, previous major surgery, surgical procedure, postoperative mortality, and morbidity. Results There were no significant differences between the two groups concerning postoperative mortality, and the duration of hospital stay and days in the postoperative intensive care unit were also similar. Complications such as pancreatic fistulas, wound infections, and pneumonia were more frequent in the older group, but the differences were not statistically significant. The overall median survival was 29.4 months and did not differ significantly between the two groups when calculated using the log-rank test (p =0.961). Discussion In the light of these findings and as reported for other series, old age is probably not directly related with any increase in the rate of postoperative complications, but comorbidities (which are naturally related to the patients’ previous life) may have a key role in the postoperative course. Keywords Pancreas . Pancreatic resection . Elderly Introduction Pancreatic cancer is the third most frequent neoplasm of the gastrointestinal tract and usually has an unfavorable prognosis. 1–3 Radical resection represents the only chance of cure for pancreatic malignancies and is also useful for other benign pathologies, such as pancreatitis. The inci- dence of pancreatic cancer is strongly age-related: People over 65 years of age are at the highest risk of developing this kind of tumor, representing 60% of all cases diag- nosed 4 , and considering the general increase in average life expectancy, the incidence of pancreatic cancer is likely to increase. The appropriate treatment of elderly potential candidates for pancreatic resection is thus becoming an important issue. Over the last two decades, medical and surgical improvements have drastically changed the post- operative outcome of elderly patients undergoing pancreatic resection, and studies have reported that age is no longer a contraindication for major pancreatic resection in survival terms. 5–7 Some preexisting comorbidities, such as chronic obstructive pulmonary disease or heart disease, can nega- J Gastrointest Surg (2009) 13:341–348 DOI 10.1007/s11605-008-0601-0 R. Ballarin (*) : M. Spaggiari : F. Di Benedetto : R. Montalti : M. Masetti : N. De Ruvo : A. Romano : G. P. Guerrini : M. G. De Blasiis : G. E. Gerunda Center for Liver and Multivisceral Transplants and HPB Surgery, University of Modena and Reggio Emilia, #71, Via del Pozzo, 41100 Modena, Italy e-mail: ballarinroberto@hotmail.com