Purpose: Elderly patients constitute a special group of surgical candidates due to the frequent coexistence of major comorbidities. We report our experience in performing liver resections in patients aged 75 years or older.
Methods: During a period of 62 months, 154 patients underwent liver resections, out of which 20 were 75 years old or older. Our prospectively maintained database was reviewed regarding patient and tumor characteristics, intraoperative and postoperative data.
Results: Out of the 20 patients aged 75 years or older, 15 were men and 5 women, with a mean age of 79.3 years. Sixteen patients (80%) had at least one major comorbidity. Indications for surgery was hepatocellular carcinoma (n=5), intrahepatic cholangiocarcinoma (n=7), liver metastases (n=5), liver abscess (n=2) and liver cyst with hemorrhage (n=1). Liver resections included 3 left hepatectomies, 1 left lateral hepatectomy combined with segmentectomy and wedge resection, 2 right hepatectomies, 1 central hepatectomy, 4 bisegmentectomies, 3 segmentectomies, 4 wedge resections and 2 unroofings of giant liver cysts. In 10 out of the 20 operations, patients underwent further procedures apart from the liver resection. Six patients were postoperatively admitted to intensive care unit for 1 or 2 days. Postoperative bile leak was documented in 2 patients and postoperative hemorrhage in 1 patient, for which no reoperation was needed. No postoperative death was recorded during the hospitalization of the patients. The mean length of hospital stay was 12.9 days.
Conclusions: Liver resections, even major ones, can be tolerated by elderly patients with good postoperative outcomes under the presupposition of careful patient selection.