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Hepatic resection in the elderly.

J G Fortner1, R M Lincer

  • 1Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.

Annals of Surgery
|February 1, 1990
PubMed
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Elderly patients undergoing major hepatic resection face a slightly increased mortality risk. Extended right hepatic lobectomy in older adults carries a significantly higher risk and should be reserved for select cases.

Area of Science:

  • Hepatobiliary Surgery
  • Geriatric Surgery
  • Surgical Oncology

Background:

  • Hepatic resection is a critical treatment for liver diseases.
  • The safety and outcomes of hepatic resection in elderly patients remain a concern.

Purpose of the Study:

  • To evaluate the operative mortality and outcomes of hepatic resection in patients aged 65 and older.
  • To assess the specific risks associated with major hepatic resection and extended right hepatic lobectomy in the elderly population.

Main Methods:

  • Retrospective review of 453 patients who underwent hepatic resection between 1970 and 1988.
  • Analysis focused on 90 patients aged 65 and older, comparing outcomes based on resection type and age.

Main Results:

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  • Overall 30-day operative mortality for hepatic resection was 3.3%.
  • For patients over 64, major hepatic resection had an 11.1% mortality rate, significantly higher than younger groups.
  • Extended right hepatic lobectomy in this elderly group had a 30.7% mortality rate, with hepatic insufficiency causing 60% of deaths.

Conclusions:

  • Major hepatic resection is feasible in elderly patients but carries a somewhat increased mortality risk.
  • Extended right hepatic lobectomy poses a markedly increased operative risk in the elderly and should be reserved for carefully selected cases due to high mortality and risk of hepatic insufficiency.