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Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
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Laparoscopic liver resection in elderly patients: systematic review and meta-analysis
Margherita Notarnicola1, Emanuele Felli2, Stefania Roselli1
1Department of Emergency and Organ Transplantation, Institute of General Surgery and Liver Transplantation, University of Bari, 70124, Bari, Italy.
Surgical Endoscopy
|May 30, 2019
Summary
Laparoscopic liver resection (LLR) is safe and feasible for elderly patients, showing fewer complications and less blood loss compared to open liver resection (OLR). LLR outcomes in the elderly are comparable to younger patients, supporting its use in this demographic.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Geriatric Surgery
Background:
- Laparoscopic liver resection (LLR) is increasingly adopted as a standard surgical approach.
- Limited data exist on the safety and feasibility of LLR specifically in elderly populations.
- Comparative data between LLR and open liver resection (OLR) in the elderly are scarce.
Purpose of the Study:
- To evaluate the feasibility and outcomes of LLR in elderly patients.
- To compare LLR versus OLR in elderly patients.
- To compare LLR outcomes between elderly and non-elderly patients.
Main Methods:
- Systematic review and meta-analysis of comparative studies.
- Searches conducted in Cochrane Library, Embase, PubMed, and Web of Science.
- Two groups analyzed: Elderly OLR vs. Elderly LLR, and Elderly LLR vs. Non-elderly LLR.
Main Results:
- In elderly patients, LLR demonstrated significantly less blood loss, reduced transfusion rates, and fewer severe postoperative complications (Clavien-Dindo III/IV) compared to OLR.
- No significant differences were found between LLR and OLR in elderly patients regarding bile leakage, ascites, mortality, liver failure, or R0 resection rates.
- Elderly and non-elderly patients undergoing LLR showed no significant differences in blood loss, transfusions, complications, mortality, ascites, bile leak, hospital stay, R0 resection, or operative time.
Conclusions:
- Laparoscopic liver resection is a safe and feasible surgical option for elderly patients.
- LLR offers advantages in terms of reduced blood loss and complications compared to OLR in the elderly.
- Further randomized controlled trials are needed to definitively confirm these findings.
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