Outcomes of Liver Resection in the Elderly: Is it safe?

BACKGROUND/AIMS: There has been an increase in the incidence of neoplasms of the liver in recent years, although there is still a fear of performing aggressive surgical procedures in elderly patients, especially regarding hepatic surgery. The objective of this study was to analyse the influence of age on the morbidity and mortality of patients undergoing hepatic resection. METHODOLOGY: This was a study of 414 patients who underwent 447 hepatic resections between November 1993 and December 2010. The patients were divided into two groups according to whether they were ≤ 65 or > 65 years of age. RESULTS: The elderly group included 113 resections, while the young group was composed of 334 procedures. The elderly group had more malignant lesions and more comorbidities. With regard to the transoperative and post-operative data, the two groups displayed similar results. According to the multivariate analysis, cirrhosis and the use of transoperative pedicular clamping were independent predictors of morbidity. Cirrhosis was also an independent predictor of mortality. CONCLUSIONS: The results indicate that age is not a predisposing factor for the worsening of results of hepatic resection in selected patients, especially with regard to cirrhosis. Moreover, surgeons must avoid the use of transoperative pedicular clamping.