Introduction : Pancreaticoduodenectomy (PD) is a highly invasive procedure and its complication rate is high. The number of elderly cancer patient increases. The present study was to investigate the postoperative short-term outcomes and oncologic long-term outcomes of PD in elderly patients and compare the results with those in younger patients.

Methods : Between January 2000 and December 2014, patients who underwent PD due to periampullary cancers in the Department of Surgery of Seoul National University Hospital were enrolled. Patients aged 75 years or over were included in the elderly group. Survival analysis was performed in R0 resection patients.

Results : Total 1249 patients were enrolled in this study and 168 patients (13.5%) were included in the elderly group. Of the entire patients, the proportion of elderly patients was increasing. In terms of short-term outcomes, postoperative complication rates (51.2 vs. 54.6%, P=0.454), duration of postoperative hospital stay (20.5 vs 20.5 days, P=0.922) and 30 days mortality (0.6 vs 0.3%, P=0.999), and were comparable between two groups, although the admission rate of ICU postoperatively was higher in the elderly than the control group (20.8 vs 10.5%, P<0.001). In terms of long-term outcomes, five-year overall survival rate was lower in the elderly group (23.4 vs 41.8%, P<0.001), and five-year recurrence-free survivals tended to be lower in the elderly group without statistical significance (36.1 vs 42.1%, P=0.095).

Conclusions : PD for periampullary cancer is a safe and feasible treatment in the elderly patients. The treatment modality for obtaining better survival outcomes including adjuvant chemotherapy will be investigated.