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. 2023 Jul;37(7):5205-5214.
doi: 10.1007/s00464-023-09986-9. Epub 2023 Mar 22.

Benefits of laparoscopic liver resection in elderly patients

Shozo Mori  1 , Taiga Wakabayashi  2 , Kohei Mishima  2 , Takahiro Ozaki  2 , Yoshiki Fujiyama  2 , Go Wakabayashi  2
Affiliations

Benefits of laparoscopic liver resection in elderly patients

Shozo Mori et al. Surg Endosc. 2023 Jul.

Abstract

Background: The indications of laparoscopic liver resection (LLR) have expanded to high-risk patients, such as elderly people. However, to date, little evidence has been established of the safety and feasibility of LLR in elderly patients. The short-term outcomes of LLR in elderly patients as compared to non-elderly patients were investigated.

Methods: Data of a total of 297 patients who underwent LLR were reviewed. Among these 297 patients, 181 patients were < 75 years age (non-elderly) and 116 patients were ≥ 75 years age (elderly), and the surgical outcomes were compared between the groups. In addition, we evaluated the risk factors for postoperative morbidity (Clavien-Dindo grade ≥ IIIa) utilizing the preoperative, operative, and postoperative variables RESULTS: The preoperative liver/renal function, frequency of anti-thrombotic drug use, number of comorbidities, and American Society of Anesthesiologists-physical status classification were more unfavorable in elderly patients than in non-elderly patients. No significant inter-group differences were observed in the operation time, blood loss, conversion rate, postoperative morbidity, or 30-day mortality. The 3-year overall survival rate was comparable between the two groups. Multivariate analysis identified anti-thrombotic drug use, operation time > 7 h, and peak serum total bilirubin > 2 mg/dl within postoperative day 3 as independent risk factors for Clavien-Dindo ≥ IIIa postoperative morbidity (P = 0.016, P < 0.001, and P = 0.001, respectively).

Conclusions: LLR in elderly patients may provide comparable short-term outcomes to those in non-elderly patients.

Keywords: Anti-thrombotic drug; Elderly patients; Laparoscopic liver resection; Postoperative morbidity; Short-term outcomes.

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