探讨高龄患者胰十二指肠切除术（PD）的围手术期安全性及疗效。

回顾性分析1994年1月至2014年12月在中山大学孙逸仙纪念医院行PD的593例患者临床资料。患者均签署知情同意书，符合医学伦理规定。根据患者的年龄分为高龄组（年龄≥70岁）与非高龄组（年龄<70岁）。其中高龄组97例，男59例，女38例；非高龄组496例，男300例，女196例。两组患者围手术期指标比较采用秩和检验，率的比较采用χ²检验或Fisher确切概率法。

高龄组中位手术时间、术中出血量分别为333（187～620）min、400（50～2 500）ml，非高龄组相应为340（180～920） min、400 （50～18 000）ml，差异无统计学意义（Z=-1.249，-0.046；P>0.05）。高龄组围手术期死亡率、总并发症发生率、二次手术率分别为11.3%、45.4%、10.3%，非高龄组相应为6.0%、40.7%、11.1%，差异无统计学意义（χ²=3.530，0.718，0.051；P>0.05）。高龄组术后手术操作相关并发症发生率35.1%，非高龄组37.9%，差异无统计学意义（χ²= 0.282，P>0.05）；而术后非手术操作相关并发症发生率为18.6%，明显高于非高龄组的9.1%（χ²= 7.686，P<0.05）。

高龄患者PD相较于非高龄患者在技术方面是同样安全的，但非手术操作相关并发症发生率相对较高，术前针对高龄患者更加全面、细致的全身评估十分必要。

To evaluate the perioperative safety and clinical efficacy of pancreatoduodenectomy (PD) in elderly patients.

Clinical data of 593 patients undergoing PD in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 1994 to December 2014 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the age, all patients were divided into the elderly group (age≥70 years,n=97, 59 males and 38 females) and non-elderly group (age<70 years, n=496, 300 males and 196 females). The perioperative parameters were compared between two groups using rank sum test. The rates were compared using Chi-square test or Fisher's exact test.

In elderly group, the median length of operative time was 333 (187-620) min and the intraoperative blood loss was 400 (50-2 500) ml, and was respectively 340 (180-920) min, 400 (50-18 000) ml in non-elderly group, where no significant difference was observed (Z=-1.249, -0.046; P>0.05). The perioperative mortality, overall incidence of complications and reoperation rate in elderly group were 11.3%, 45.4% and 10.3% , and were 6.0%, 40.7% and 11.1% respectively in non-elderly group, where no significant difference was observed (χ2=3.530, 0.718, 0.051; P>0.05). The incidence of operation-related complications was 35.1% in elderly group, and was 37.9% in non-elderly group, where no significant difference was observed (χ2=0.282, P>0.05). The incidence of non-operation-related complications was 18.6% in elderly group, significantly higher than 9.1% in non-elderly group (χ2=7.686, P<0.05).

For elderly patients, PD is technically safe as non-elderly patients. However, the incidence of non-operation-related complications is higher in elderly patients comparatively. A more comprehensive and detailed physical assessment is necessary before operation for the elderly patients.