Surgical Outcomes of Laparoscopic Liver Resection in Elderly Patients

Abstract

The life expectancy continues to gradually increase worldwide. Laparoscopic liver resection (LLR) was recently reported to be a relatively safe procedure for treatment of liver disease because of the development of new techniques and instruments. The aim of this study was to evaluate the surgical outcomes of elderly patients who underwent LLR. Of these 61 patients who underwent LLR in our institute from January 2010 through April 2014, 21 were aged 75 years and above (group E), and 40 were aged below 75 years (group NE). Patient characteristics were retrospectively analyzed between the 2 groups. The results showed that patient characteristics were similar between the 2 groups, although the incidence of hypertension was significantly greater among patients in group E. There were no significant differences in the incidence of postoperative complications or length of hospital stay between the 2 groups. In conclusion, LLR for elderly patients was a feasible procedure compared with nonelderly patients.

Laparoscopic hepatectomy for elderly patients

“…[ 16 , 17 ] Finally, 9 studies were selected for further meta-analysis. [ 18 – 26 ] Of these, 5 studies compared LH and OH among elderly patients, [ 22 – 26 ] 3 evaluated the safety and feasibility of LH among elderly patients compared to nonelderly patients also receiving LH [ 18 – 20 ] and 1 compared the outcomes of LH for both elderly patients with nonelderly patients to LH and OH among elderly patients. [ 21 ] No randomized controlled trial (RCT) was found.…”

“…[ 19 , 22 – 24 , 26 ] Five studies used 70 years as the age cutoff the elderly label, [ 18 , 19 , 22 , 23 , 26 ] whereas 1 study used 65 years [ 24 ] and the other 3 studies used 75. [ 20 , 21 , 25 ] The indications of 2 studies included benign liver lesions and malignancy. [ 20 , 21 ] The indications of the remaining 7 studies were reported as malignant, with colorectal metastases the most frequently recorded.…”

“…[ 20 , 21 , 25 ] The indications of 2 studies included benign liver lesions and malignancy. [ 20 , 21 ] The indications of the remaining 7 studies were reported as malignant, with colorectal metastases the most frequently recorded. One study was only restricted to primary hepatocellular carcinoma.…”

“…[ 25 ] The majority type of intervention was total or pure laparoscopic hepatic resection, but 1 study used hand-assisted or hybrid procedures. [ 20 ] All of the included studies graded morbidity according to the Clavien-Dindo Classification. The definition of mortality was 90 days in 5 studies, which included perioperative death cases, [ 18 , 19 , 21 , 25 , 26 ] and 1 study used 30-day mortality.…”

A Comparison of Short-Term Outcomes between Laparoscopic and Open Liver Resection in Elderly Patients

“…Many studies have reported that LLR showed improved surgical and postoperative outcomes. 6,13,[20][21][22] With these evidences, the indications for LLR have been expanded to malignancies and major hepatectomies, and further studies have proven the safety and acceptable morbidity and mortality rates of LLR. Also, advancements in postoperative care and improvements in laparoscopic instruments have made LLR more feasible for the treatment of neoplastic liver disease.…”