Postoperative liver function after elective right hepatectomy in elderly patients.

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Geriatric Medicine

Background:

• The impact of advanced age on liver resection outcomes remains debated.
• Evaluating major liver resection safety and efficacy in elderly patients is crucial.

Purpose of the Study:

• To assess the outcomes of major liver resection in patients aged 65 years and older.
• To compare operative deaths, morbidity, and postoperative liver function in elderly versus younger patients undergoing elective right hepatectomy.

Main Methods:

• Retrospective analysis of 24 patients (≥65 years) and 22 patients (<40 years) who underwent elective right hepatectomy (segments V-VIII) for malignant liver tumors between 1990-1997.
• Comparison of operative mortality, severe complications, liver function tests (prothrombin time, total serum bilirubin, aminotransferases, GGT, ALP), and hospital stay.

Main Results:

• Elective right hepatectomy in patients aged 65+ demonstrated comparable mortality (1 vs 0 deaths) and severe complication rates (12% vs 5%) to younger patients.
• Postoperative liver function, including prothrombin time and total serum bilirubin levels, showed no significant differences between the elderly and younger cohorts on postoperative days 2, 5, and 8.
• Similar levels of aminotransferases, gamma-glutamyl transpeptidase, and alkaline phosphatase were observed in both age groups, with a mean hospital stay of 15 days for older patients and 13 days for younger patients.

Conclusions:

• Elective right hepatectomy in selected elderly patients (≥65 years) is associated with postoperative liver function comparable to that of younger patients.
• Age should not be an absolute contraindication for major liver resection in carefully selected older individuals.
• These findings support the safety and feasibility of major liver surgery in the geriatric population.