title: Laparoscopic versus open liver resection for elderly patients with malignant liver tumors: a single-center experience.
abstract: BACKGROUND
  Laparoscopic liver resection is associated with less perioperative blood loss, shorter hospital stay, and fewer postoperative complications in younger patients. However, it remains unclear if these short-term benefits could also be applicable to elderly patients with medical comorbidities.
  
  
  OBJECTIVE
  To evaluate the perioperative outcomes of laparoscopic liver resection in patients with advanced age.
  
  
  METHODS
  Patients aged ≥ 70 years old who received liver resections for malignant liver tumors between January 2002 and December 2012 were included. The perioperative outcomes of 17 patients with laparoscopic approach were matched and compared with 34 patients with conventional open approach in a 1:2 ratio.
  
  
  RESULTS
  There was no significant difference with regard to age, gender, incidence of comorbid illness, hepatitis B positivity, and Child grading of liver function. The median tumor size was 3 cm for both groups. The types of liver resection were similar between the two groups with no significant difference in the duration of operation (laparoscopic: 195 min vs open: 210 min, P = 0.436). The perioperative blood loss was 150 mL in the laparoscopic group and 330 mL in the open group (P = 0.046) with no significant difference in the number of patients with blood transfusion. The duration of hospital stay was 6 days (3-15 days) for the laparoscopic group and 8 days (5-105 days) for the open group (P = 0.005).
  
  
  CONCLUSIONS
  Laparoscopic liver resection is safe and feasible for elderly patients. The short-term benefits of laparoscopic approach continued to be evident for geriatric oncological liver surgery.
authors: Division of Hepatobiliary and Pancreatic Surgery, and Liver Transplantation, Department of Surgery, The University of Hong Kong, Hong Kong.
authors: Albert C Y
authors: AC
authors: Chan
authors: Ronnie T P
authors: RT
authors: Poon
authors: Tan To
authors: TT
authors: Cheung
authors: Kenneth S H
authors: KS
authors: Chok
authors: Wing Chiu
authors: WC
authors: Dai
authors: See Ching
authors: SC
authors: Chan
authors: Chung Mau
authors: CM
authors: Lo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome
keywords: hepatectomy; hepatocellular carcinoma; laparoscopic resection; liver cancer; liver resection