Total laparoscopic pylorus‑preserving pancreatoduodenectomy in an 89-year-old man: A case report and review of a single institute's experience in elderly patients

Abstract

Total laparoscopic pylorus‑preserving pancre­atoduodenectomy (tLPPPD) has been demonstrated to be a safe and feasible surgery for pancreatic malignant diseases located in the head or uncinate process, with the advantages including minimal invasion, lower blood loss and a shorter hospital stay, compared with traditional open pancreato­duodenonectomy. Elderly patients theoretically have a lower capability to tolerate complex surgeries. The impairment of heart and pulmonary reserve function often leads to a high risk of post‑operative cardiopulmonary complications. The present study reports a case of tLPPPD that was successfully performed in an 89‑year‑old man. No fatal complications developed. The post‑operative pathological result revealed a diagnosis of pancreatic uncinate adenocarcinoma (T2N0M0, stage IB). After 1 year of follow‑up, the patient remained alive without tumor recurrence or metastasis. The present study also discusses the associated literature and concludes that tLPPPD is a safe and feasible procedure in selective elderly patients. Use of this technique may expand the number of patients who can undergo surgery and provide benefits to these patients.