老年患者腹腔镜胰十二指肠切除术（LPD）的可行性和安全性仍存在争议。本研究旨在比较老年患者行LPD和开腹胰十二指肠切除术（OPD）的临床结局。对2015年至2022年间接受LPD或OPD的老年患者（≥65岁）的临床和随访资料进行回顾性分析。进行 1:1 倾向评分匹配 (PSM) 分析，以尽量减少组间差异。采用单因素和多因素logistic回归分析选择90天死亡率的独立预后因素。在410名老年患者中，236名接受了LPD，174名接受了OPD。 PSM 后，LPD 组的估计失血量 (EBL) 较少（100 vs. 200 mL，P < 0.001），术中输血率较低（10.4% vs. 19.0%，P = 0.029），淋巴结采集较多（ 11.0 vs. 10.0，P = 0.014）和较短的术后住院时间（LOS）（13.0 vs. 16.0 天，P = 0.013）。严重并发症率、再次手术率、90天再入院率及死亡率差异均无统计学意义（均P≥0.05）。多因素logistic回归分析显示，胰腺切除术后出血（PPH）是90天死亡率的独立危险因素。接受LPD或OPD的老年胰腺导管腺癌（PDAC）患者PSM后总生存期（OS）相似（22.5 vs.20.4个月，P = 0.672）。术后LOS更短。接受 LPD 或 OPD 的老年 PDAC 患者的长期生存结果没有统计学上的显着差异。© 2024。作者。

The feasibility and safety of laparoscopic pancreatoduodenectomy (LPD) in elderly patients is still controversial. This study aimed to compare the clinical outcomes of LPD and open pancreatoduodenectomy (OPD) in elderly patients.Clinical and follow-up data of elderly patients (≥ 65 years) who underwent LPD or OPD between 2015 and 2022 were retrospectively analyzed. A 1:1 propensity score-matching (PSM) analysis was performed to minimize differences between groups. Univariate and multivariate logistic regression analysis were used to select independent prognostic factors for 90-day mortality.Of the 410 elderly patients, 236 underwent LPD and 174 OPD. After PSM, the LPD group had a less estimated blood loss (EBL) (100 vs. 200 mL, P < 0.001), lower rates of intraoperative transfusion (10.4% vs. 19.0%, P = 0.029), more lymph node harvest (11.0 vs. 10.0, P = 0.014) and shorter postoperative length of stay (LOS) (13.0 vs. 16.0 days, P = 0.013). There were no significant differences in serious complications, reoperation, 90-day readmission and mortality rates (all P > 0.05). Multivariate logistic regression analysis showed that post-pancreatectomy hemorrhage (PPH) was an independent risk factor for 90-day mortality. Elderly patients with pancreatic ductal adenocarcinoma (PDAC) who underwent LPD or OPD had similar overall survival (OS) (22.5 vs.20.4 months, P = 0.672) after PSM.It is safe and feasible for elderly patients to undergo LPD with less EBL and a shorter postoperative LOS. There was no statistically significant difference in long-term survival outcomes between elderly PDAC patients who underwent LPD or OPD.© 2024. The Author(s).