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Early Outcome Following Hepatic Resection in Patients Older Than 80 Years of Age

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Abstract

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.

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References

  1. Ezaki T, Ezaki T, Yukaya H et al (1987) Evaluation of hepatic resection for hepatocellular carcinoma in the elderly. Br J Surg 74:471–473

    Article  PubMed  CAS  Google Scholar 

  2. Yanaga K, Kanematsu T, Takenaka K et al (1988) Hepatic resection for hepatocellular carcinoma. Am J Surg 155:238–240

    Article  PubMed  CAS  Google Scholar 

  3. Wu CC, Chen JT, Ho WL et al (1999) Liver resection for hepatocellular carcinoma in octogenarians. Surgery 125:332–338

    PubMed  CAS  Google Scholar 

  4. Yeh CN, Lee WC, Jeng LB et al (2004) Hepatic resection for hepatocellular carcinoma in elderly patients. Hepatogastroenterology 51:219–222

    PubMed  Google Scholar 

  5. Hanazaki K, Kajikawa S, Shimozawa N et al (2001) Hepatic resection for hepatocellular carcinoma in the elderly. J Am Coll Surg 192:38–46

    Article  PubMed  CAS  Google Scholar 

  6. Ferrero A, Vigano L, Polastri R et al (2005) Hepatectomy as treatment of choice for hepatocellular carcinoma in elderly cirrhotic patients. World J Surg 29:1101–1105

    Article  PubMed  Google Scholar 

  7. Zieren HU, Muller JM, Zieren J (1994) Resection of colorectal liver metastases in old patients. Hepatogastroenterology 41:34–37

    PubMed  CAS  Google Scholar 

  8. Fong Y, Blumgart LH, Fortnet JG et al (1995) Pancreatic or liver resection for malignancy is safe and effective for the elderly. Ann Surg 222:426–429

    Article  PubMed  CAS  Google Scholar 

  9. Brunken C, Rogiers X, Malago M et al (1998) Is resection of colorectal liver metastases still justified in very elderly patients? Chirurg 69:1334–1338

    Article  PubMed  CAS  Google Scholar 

  10. Brand MI, Saclaridis TJ, Dobson HD et al (2000) Liver resection for colorectal cancer: liver metastases in the aged. Am Surg 66:412–416

    PubMed  CAS  Google Scholar 

  11. Cescon M, Grazi GL, Gaudio MD et al (2003) Outcome of right hepatectomies in patients older than 70 years. Arch Surg 138:547–552

    Article  PubMed  Google Scholar 

  12. Petrowsky H, Clavien P (2005) Should we deny surgery for malignant hepato-pancreatico-biliary tumors to elderly patients? World J Surg 29:1093–1100

    Article  PubMed  Google Scholar 

  13. Shimada M, Takenaka K, Fujiwara Y et al (1998) Risk factors linked to postoperative morbidity in patients with hepatocellular carcinoma. Br J Surg 85:195–198

    Article  PubMed  CAS  Google Scholar 

  14. Shirabe K, Shimada M, Gion T et al (1999) Postoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume. J Am Coll Surg 188:304–307

    Article  PubMed  CAS  Google Scholar 

  15. Rahbari NN, Koch M, Mehabi A et al (2008) Portal triad clamping versus vascular exclusion for vascular control during hepatic resection: a systematic review and meta-analysis. J Gastrointest Surg 13:558–568

    Article  PubMed  Google Scholar 

  16. Otsubo T, Takasaki K, Yamamoto M et al (2004) Bleeding during hepatectomy can be reduced by clamping the inferior vena cava below the liver. Surgery 135:67–73

    Article  PubMed  Google Scholar 

  17. Ogata S, Belghiti J, Varma D et al (2007) Two hundred liver hanging maneuvers for major hepatectomy: a single-center experience. Ann Surg 245:31–35

    Article  PubMed  Google Scholar 

  18. World Health Organization (2008) Core health indicators. Available at http://www.who.int/whosis/database/core/core_select.cfm. Accessed June 2009

  19. Centers for Disease Control and Prevention (2009) Available at http://www.cdc.gov/nchs/fastats/lifexpec.htm. Accessed June 2009

  20. Watabe H, Shiratori Y, Takeishi R et al (2003) Clinical features of patients with HCC who are negative both HBV and HCV markers. Hepatogastroenterology 50:2157–2160

    PubMed  Google Scholar 

  21. Belghiti J, Marty J, Farges O (1999) Technique, hemodynamic monitoring, and indications for vascular clamping during liver resection. Ann Surg 229:369–375

    Article  PubMed  CAS  Google Scholar 

  22. Cunningham JD, Fong Y, Shriver C et al (1994) One hundred consecutive hepatic resections. Blood loss, transfusion, and operative technique. Arch Surg 129:1050–1061

    PubMed  CAS  Google Scholar 

  23. Menon KV, Mukhtar AA, Aldouri A et al (2006) Outcomes after major hepatectomy in elderly patients. J Am Coll Surg 203:677–683

    Article  PubMed  Google Scholar 

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Correspondence to Ken Shirabe.

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Shirabe, K., Kajiyama, K., Harimoto, N. et al. Early Outcome Following Hepatic Resection in Patients Older Than 80 Years of Age. World J Surg 33, 1927–1932 (2009). https://doi.org/10.1007/s00268-009-0122-3

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  • DOI: https://doi.org/10.1007/s00268-009-0122-3

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