Laparoscopic versus open liver resection for elderly patients with malignant liver tumors: A single-center experience

Abstract

Background: Laparoscopic liver resection is associated with less perioperative blood loss, shorter hospital stay, and fewer postoperative complications in younger patients. However, it remains unclear if these short-term benefits could also be applicable to elderly patients with medical comorbidities. Aim: To evaluate the perioperative outcomes of laparoscopic liver resection in patients with advanced age. Materials and Methods: Patients aged ≥70 years old who received liver resections for malignant liver tumors between January 2002 and December 2012 were included. The perioperative outcomes of 17 patients with laparoscopic approach were matched and compared with 34 patients with conventional open approach in a 1:2 ratio. Results: There was no significant difference with regard to age, gender, incidence of comorbid illness, hepatitis B positivity, and Child grading of liver function. The median tumor size was 3cm for both groups. The types of liver resection were similar between the two groups with no significant difference in the duration of operation (laparoscopic: 195min vs open: 210min, P=0.436). The perioperative blood loss was 150mL in the laparoscopic group and 330mL in the open group (P=0.046) with no significant difference in the number of patients with blood transfusion. The duration of hospital stay was 6 days (3-15 days) for the laparoscopic group and 8 days (5-105 days) for the open group (P=0.005). Conclusion: Laparoscopic liver resection is safe and feasible for elderly patients. The short-term benefits of laparoscopic approach continued to be evident for geriatric oncological liver surgery. © 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.