Early outcome following hepatic resection in patients older than 80 years of age.
BACKGROUND
We aimed to study the early outcome of patients 80 years of age and older undergoing liver resection and to compare the results with the outcomes of patients younger than 80 years of age.


METHODS
All 350 consecutive patients undergoing hepatic resections from 2004 April to 2008 October were included. Patients were divided into two groups: 80 years of age and older (group I; n = 43) and less than 80 years of age (group II; n = 307). Preoperative clinicopathological features, intraoperative factors, in-hospital mortality, postoperative complications, length of hospital stay, operative mortality, morbidity, and prognosis after discharge were analyzed and compared between groups I and II.


RESULTS
There was no significant difference between the two groups regarding the indication for hepatic resection. Hepatitis viral status was significantly different between groups: patients without hepatitis B or C viral infection were more common in group I than in group II. Regarding preoperative liver function, serum levels of albumin were significantly lower in group I than in group II. Although the operative time was significantly shorter in group I than in group II, no difference was found between groups regarding such operative factors as type of hepatectomy, blood loss, and rate of blood transfusion. After elimination of 16 patients with extrahepatic bile duct resection and reconstruction, no difference existed between the two groups in operative time. There was no postoperative mortality nor in-hospital mortality in group I; in group II one postoperative death (0.3%) and two in-hospital deaths (0.6%) were recorded. There was no difference between groups in the incidence of morbidity and early prognosis after discharge.


CONCLUSIONS
The results indicate that hepatic resection for elderly patients over 80 can be safely performed given careful patient selection.
Shirabe
Ken
K
Department of Hepatogastroenterological Surgery, Aso Iizuka Hospital, Iizuka City, 820-8505, Japan. kshirabe@surg2.med.kyushu-u.ac.jp
Kajiyama
Kiyoshi
K
Harimoto
Norifumi
N
Gion
Tomonobu
T
Tsujita
Eiji
E
Abe
Tomoyuki
T
Wakiyama
Shigeki
S
Nagaie
Takashi
T
Maehara
Yoshihiko
Y
D000367:Age Factors; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery*; D016009:Chi-Square Distribution; D005260:Female; D006498:Hepatectomy / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome