Outcomes following Pancreatoduodenectomy in Patients ≥80 Years: An Analysis of the Prospective Pancreas Registry of the German Society for General and Visceral Surgery (DGAV|Registry Pancreas).
11 affiliations
- 1Department of General Surgery, Visceral-, Vascular- and Paediatric Surgery, Saarland University Medical Center, Homburg, Germany.
- 2Department of General, Visceral and Transplant Surgery, University Hospital Münster, Münster, Germany.
- 3Department of General, Visceral and Paediatric Surgery, University Medical Center Göttingen, Göttingen, Germany.
- 4Department of Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- 5Department of General and Visceral Surgery, University of Freiburg Medical Center, Faculty of Medicine, Freiburg, Germany.
- 6Department of General and Visceral Surgery, Helios Kliniken Schwerin, Schwerin, Germany.
- 7Department of General Surgery, University Medical Center Schleswig Holstein, Campus Lübeck, Lübeck, Germany.
- 8Department of General and Visceral Surgery, St. Josef- Hospital Bochum, Ruhr University Bochum, Bochum, Germany.
- 9German Society for General and Visceral Surgery (DGAV), Haus der Bundespressekonferenz, Berlin, Germany.
- 10Department for General, Visceral, Thoracic and Vascular Surgery, University Hospital of Bonn, Bonn, Germany.
- 11Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Munich, Germany.
Abstract
Introduction
With rising life expectancy, the number of elderly patients undergoing pancreatoduodenectomy is steadily increasing. This study aimed to assess peri- and postoperative outcomes in patients aged ≥ 80 years undergoing pancreatoduodenectomy, using data from the DGAV|registry pancreas.Methods
All pancreatoduodenectomies performed between September 2013 and April 2024 and recorded in the DGAV|registry pancreas were retrospectively analyzed. Patients were divided into two groups: <80 and ≥80 years. Demographic, perioperative, and postoperative data were compared. A multivariate analysis was conducted to identify independent risk factors for in-hospital mortality.Results
Out of 12,305 pancreatoduodenectomies, 1,566 (12.7%) were performed in patients aged ≥ 80 years. The proportion of very elderly patients more than doubled from 6.9% in 2014 to a peak of 17.3% in 2021. Malignant diseases, particularly pancreatic ductal adenocarcinoma, were more common in this group. While overall complication rates were slightly higher in the elderly (64.0% vs. 60.7%, p = 0.013), there was no significant difference in severe complications (Clavien-Dindo grades 3 and 4). However, 30-day mortality (7.2% vs. 3.6%) and in-hospital mortality (8.2% vs. 4.4%) were significantly higher in patients aged ≥ 80 years. Cardiopulmonary complications were also more frequent. Multivariate analysis identified age ≥ 80, male sex, ASA class 3 or 4, obesity, COPD, anticoagulant therapy, the need for intraoperative blood transfusions, and extended resections as independent predictors of in-hospital mortality.Conclusion
Chronological age ≥ 80 years is associated with increased postoperative morbidity and mortality after pancreatoduodenectomy. However, age alone should not be considered an exclusion criterion. Careful patient selection, taking biological age, comorbidities, and functional status into account, is essential. Integrating geriatric expertise and prehabilitation strategies may improve outcomes in this growing patient population.
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BibTeX
@article{scherber2026outcomes,
title = {{Outcomes following Pancreatoduodenectomy in Patients ≥80 Years: An Analysis of the Prospective Pancreas Registry of the German Society for General and Visceral Surgery (DGAV|Registry Pancreas).}},
author = {Philipp Scherber and Sebastian Holländer and Gereon Gäbelein and Dorian Igna and Peter Jacob and Andreas Pascher and Michael Ghadimi and Christoph Reissfelder and Stefan Fichtner-Feigl and Jörg-Peter Ritz and Tobias Keck and Waldemar Uhl and Carsten Klinger and Heinz Buhr and Jörg C Kalff and Jens Werner and Matthias Glanemann},
journal = {Visceral medicine},
year = {2026},
month = oct,
doi = {10.1159/vis/aeyag003},
url = {https://europepmc.org/article/MED/42910254},
note = {CC BY},
}
RIS
TY - JOUR
TI - Outcomes following Pancreatoduodenectomy in Patients ≥80 Years: An Analysis of the Prospective Pancreas Registry of the German Society for General and Visceral Surgery (DGAV|Registry Pancreas).
AU - Philipp Scherber
AU - Sebastian Holländer
AU - Gereon Gäbelein
AU - Dorian Igna
AU - Peter Jacob
AU - Andreas Pascher
AU - Michael Ghadimi
AU - Christoph Reissfelder
AU - Stefan Fichtner-Feigl
AU - Jörg-Peter Ritz
AU - Tobias Keck
AU - Waldemar Uhl
AU - Carsten Klinger
AU - Heinz Buhr
AU - Jörg C Kalff
AU - Jens Werner
AU - Matthias Glanemann
PY - 2026
DA - 2026/10/10
JO - Visceral medicine
DO - 10.1159/vis/aeyag003
UR - https://europepmc.org/article/MED/42910254
AB - Introduction With rising life expectancy, the number of elderly patients undergoing pancreatoduodenectomy is steadily increasing. This study aimed to assess peri- and postoperative outcomes in patients aged ≥ 80 years undergoing pancreatoduodenectomy, using data from the DGAV|registry pancreas.Methods All pancreatoduodenectomies performed between September 2013 and April 2024 and recorded in the DGAV|registry pancreas were retrospectively analyzed. Patients were divided into two groups: <80 and ≥80 years. Demographic, perioperative, and postoperative data were compared. A multivariate analysis was conducted to identify independent risk factors for in-hospital mortality.Results Out of 12,305 pancreatoduodenectomies, 1,566 (12.7%) were performed in patients aged ≥ 80 years. The proportion of very elderly patients more than doubled from 6.9% in 2014 to a peak of 17.3% in 2021. Malignant diseases, particularly pancreatic ductal adenocarcinoma, were more common in this group. While overall complication rates were slightly higher in the elderly (64.0% vs. 60.7%, p = 0.013), there was no significant difference in severe complications (Clavien-Dindo grades 3 and 4). However, 30-day mortality (7.2% vs. 3.6%) and in-hospital mortality (8.2% vs. 4.4%) were significantly higher in patients aged ≥ 80 years. Cardiopulmonary complications were also more frequent. Multivariate analysis identified age ≥ 80, male sex, ASA class 3 or 4, obesity, COPD, anticoagulant therapy, the need for intraoperative blood transfusions, and extended resections as independent predictors of in-hospital mortality.Conclusion Chronological age ≥ 80 years is associated with increased postoperative morbidity and mortality after pancreatoduodenectomy. However, age alone should not be considered an exclusion criterion. Careful patient selection, taking biological age, comorbidities, and functional status into account, is essential. Integrating geriatric expertise and prehabilitation strategies may improve outcomes in this growing patient population.
SN - 2297-4725
SN - 2297-475X
ER -