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. 1990 Feb;211(2):141–145. doi: 10.1097/00000658-199002000-00005

Hepatic resection in the elderly.

J G Fortner 1, R M Lincer 1
PMCID: PMC1357957  PMID: 2301993

Abstract

Between July 1, 1970 and December 31, 1988, 453 patients underwent hepatic resection by the senior author. Ninety of these patients were more than 64 years old and are the subject of this review. The 30-day operative mortality rate for all patients undergoing hepatic resection was 3.3%: major hepatic resection was 4.4% and subsegmental resection was 1.4%. The operative mortality rate for patients undergoing major hepatic resection increased incrementally with age: for patients up to age 55 years it was 0.70%, for those between 55 and 64 years it was 3.6%, and for patients older than 64 years it increased to 11.1%. This higher operative mortality rate in the elderly reflects the mortality rate for extended right hepatic lobectomy in this age group of 30.7%. If this procedure is excluded, the operative mortality rate for patients older than age 64 was 7.6%. Sixty per cent of the operative deaths were due to hepatic insufficiency. The data presented demonstrate that major hepatic resection can be performed in the elderly with a low but somewhat increased mortality risk. However, because of its markedly increased operative risk, extended right hepatic lobectomy should be performed in elderly patients only in selected cases until better methods of estimating hepatic reserve are available.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Cady B., McDermott W. V. Major hepatic resection for metachronous metastases from colon cancer. Ann Surg. 1985 Feb;201(2):204–209. doi: 10.1097/00000658-198502000-00012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Coppa G. F., Eng K., Ranson J. H., Gouge T. H., Localio S. A. Hepatic resection for metastatic colon and rectal cancer. An evaluation of preoperative and postoperative factors. Ann Surg. 1985 Aug;202(2):203–208. doi: 10.1097/00000658-198508000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Ekberg H., Tranberg K. G., Andersson R., Lundstedt C., Hägerstrand I., Ranstam J., Bengmark S. Determinants of survival in liver resection for colorectal secondaries. Br J Surg. 1986 Sep;73(9):727–731. doi: 10.1002/bjs.1800730917. [DOI] [PubMed] [Google Scholar]
  4. Ezaki T., Yukaya H., Ogawa Y. Evaluation of hepatic resection for hepatocellular carcinoma in the elderly. Br J Surg. 1987 Jun;74(6):471–473. doi: 10.1002/bjs.1800740614. [DOI] [PubMed] [Google Scholar]
  5. Fortner J. G., Kim D. K., Maclean B. J., Barrett M. K., Iwatsuki S., Turnbull A. D., Howland W. S., Beattie E. J., Jr Major hepatic resection for neoplasia: personal experience in 108 patients. Ann Surg. 1978 Sep;188(3):363–371. doi: 10.1097/00000658-197809000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Fortner J. G., MacLean B. J., Kim D. K., Howland W. S., Turnbull A. D., Goldiner P., Carlon G., Beattie E. J., Jr The seventies evolution in liver surgery for cancer. Cancer. 1981 May 1;47(9):2162–2166. doi: 10.1002/1097-0142(19810501)47:9<2162::aid-cncr2820470909>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  7. Fortner J. G. Recurrence of colorectal cancer after hepatic resection. Am J Surg. 1988 Mar;155(3):378–382. doi: 10.1016/s0002-9610(88)80086-2. [DOI] [PubMed] [Google Scholar]
  8. Fortner J. G., Silva J. S., Golbey R. B., Cox E. B., Maclean B. J. Multivariate analysis of a personal series of 247 consecutive patients with liver metastases from colorectal cancer. I. Treatment by hepatic resection. Ann Surg. 1984 Mar;199(3):306–316. doi: 10.1097/00000658-198403000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. James O. F. Gastrointestinal and liver function of old age. Clin Gastroenterol. 1983 Sep;12(3):671–691. [PubMed] [Google Scholar]
  10. Mohr D. N. Estimation of surgical risk in the elderly: a correlative review. J Am Geriatr Soc. 1983 Feb;31(2):99–102. doi: 10.1111/j.1532-5415.1983.tb05421.x. [DOI] [PubMed] [Google Scholar]
  11. Mooney H., Roberts R., Cooksley W. G., Halliday J. W., Powell L. W. Alterations in the liver with ageing. Clin Gastroenterol. 1985 Oct;14(4):757–771. [PubMed] [Google Scholar]
  12. Nordlinger B., Quilichini M. A., Parc R., Hannoun L., Delva E., Huguet C. Hepatic resection for colorectal liver metastases. Influence on survival of preoperative factors and surgery for recurrences in 80 patients. Ann Surg. 1987 Mar;205(3):256–263. doi: 10.1097/00000658-198703000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Stimpson R. E., Pellegrini C. A., Way L. W. Factors affecting the morbidity of elective liver resection. Am J Surg. 1987 Feb;153(2):189–196. doi: 10.1016/0002-9610(87)90812-9. [DOI] [PubMed] [Google Scholar]
  14. Yanaga K., Kanematsu T., Takenaka K., Matsumata T., Yoshida Y., Sugimachi K. Hepatic resection for hepatocellular carcinoma in elderly patients. Am J Surg. 1988 Feb;155(2):238–241. doi: 10.1016/s0002-9610(88)80703-7. [DOI] [PubMed] [Google Scholar]
  15. Yanaga K., Kanematsu T., Takenaka K., Sugimachi K. Intraperitoneal septic complications after hepatectomy. Ann Surg. 1986 Feb;203(2):148–152. doi: 10.1097/00000658-198602000-00007. [DOI] [PMC free article] [PubMed] [Google Scholar]

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