KUMJ | VOL. 13 | NO. 1 | ISSUE 49 | JAN-MAR, 2015
Early Outcome of Liver Resections in Octogenarians
Bhandari RS, Riddiough G, Muralidharan V, Christophi C
Abstract: Background
Reports on safety and feasibility of liver resection in patients 80 years and older are
very limited.
Objective
Here, we intend to analyze the perioperative outcomes of liver resections in
octogenarians performed at a single tertiary level teaching hospital over a ten years
period.
Method
Retrospective review of the medical records (between 2004 to 2014) of patients
of the defined age group was performed. Clinicopathological features, indications,
extent of resections, intraoperative parameters, postoperative complications and
final outcome were analyzed. Findings were compared with similar studies published
in literature.
Result
Total 19 (11 male, 8 female, maximum age 85 years) patients of the study group
underwent liver resection during the defined period. Commonest indication was
colorectal liver metastasis (9 patients). One patient had pancreaticodudenectomy
for periampullary malignancy four years prior to present with liver metastasis and
subsequently had liver resection for recurrence of disease. Except one, all had open
surgery. Types of resection ranged from sub segmental to major right (8 patients)
and left (1 patient) hepatectomy. Total 3 (27%) out of 11 patients on whom drain
was not placed required radiological drainage of abdominal collection. One patient
developed liver abscess postoperatively and was also successfully drained under
radiological guidance. Only 2 (10.5%) had prolonged Intensive Care Unit (ICU) stay
and remaining patients were discharged to ward after 24 hrs of observation in high
dependency/Intensive care unit. Median hospital stay was 11 days. Postoperative
complications were 3 of grade II, 4 of grade IIIa, 1 of IIIb and 2 of IVa. Total 9 patients
were discharged to rehabilitation centers and remaining 10 could be discharged
home. There was 0% mortality.
Conclusion
In appropriately selected cases, when performed in specialized tertiary centers
excellent perioperative outcomes of liver resections can be achieved even in patients
of 80 years of age and above.
Keyword : Elderly, liver, morbidity, mortality, octogenarians, resection
