Liver resection in the elderly: A retrospective cohort study of 460 patients - Feasible and safe.

ABSTRACT

INTRODUCTION: The aim of this study was to determine the influence of age on the early postoperative outcome after liver surgery. MATERIAL AND METHODS: Between January 2005 and July 2012 460 hepatic resections were performed in patients aged 60 years or younger and 70 years or older at the University Hospital Aachen and University Hospital Maastricht. The postoperative outcome of hepatic resection was evaluated by the time of intensive care unit (ICU) stay, length of hospital stay, appearance of postoperative complications and in-hospital mortality. RESULTS: The median postoperative hospital stay was 7 days in group ≤60 and 8 days in group ≥70 (p = 0.007). The median time of ICU stay was 1 day in both groups. There were no statistically significant differences according to liver related complications. In group ≥70, significantly more patients suffered from pneumonia (8% vs. 2% in group ≤60, p = 0.015). The overall mortality rate was 3.5%. CONCLUSION: Age alone should not be a contraindication for liver resection. However, elderly patients who develop pneumonia are at high risk for postoperative mortality. Therefore, factors such as short time of invasive ventilation, direct and intensive respiratory therapy and mobilization are of particular importance and should be focused on even more.