Liver resection in octogenarians

Liver resections are increasingly being performed safely in elderly patients. There are no present reports of the operative safety of liver resection in octogenarians who represents a rapidly increasing segment of the population. The purpose of this study was to analyse the results of liver resection in octogenarians over a 5 year period within a tertiary referral liver surgery unit.

Prospective data collection and analysis of octogenarians having liver resection between 1999 and 2004. Retrospective detailed case note analysis was performed to determine peri-operative mortality and morbidity. Comparison were made to other large series of liver resection in younger patient cohorts. The primary outcome measure was 30 day mortality and secondarily a detailed analysis of post-operative complications was performed.

A total 15 octogenarians (median age 82) were identified from the database. There was 1 peri-operative mortality. The remaining patients were all alive at 1, 3 and 6 month follow-ups with a median follow-up of 18 months. The commonest indication for liver resection was metastatic colorectal cancer (n=1). The median operating time was 142.5 minutes and 67% of patients (n=10) had portal clamping for a median of 21.5 minutes. The median length of hospitalization was 12 days with an ICU stay of 1 day, 27% (n=4) had major surgical complications. A further 20% (n=3) had exacerbations of pre-existing comorbidities.

Liver resection can be performed safely in octogenarians within a tertiary referral unit. It has a low mortality and an acceptable level of morbidity in carefully selected octogenarians.