Laparoscopic versus open hepatectomy for elderly patients with hepatocellular carcinoma

Purpose: The number of surgical operations for elderly patients with hepatocellular carcinoma increases as the population ages. The aim of this study was to evaluate surgical and survival outcomes in elderly patients who underwent laparoscopic or open hepatectomy for hepatocellular carcinoma. Methods: We analyzed the data of 169 patients aged 70 or over who underwent hepatectomy for hepatocellular carcinom between January 2013 and December 2018. Sixty-four pairs were selected after propensity score matching for laparoscopic or open hepatectomy for hepatocellular carcinoma. Baseline data, surgery time, length of hospital stay, postoperative complications, pathological data, overall survival, and disease-free survival were investigated. Results: Operative time in the laparoscopic group was long- er than in the open group. Blood loss and postoperative hospital stay were shorter in the laparoscopic group than in the open group. The rate of postoperative 30-day minor or major complications was similar between the two groups. There was no significant difference in pathological data between the two groups. There was no significant difference in overall survival and disease free survival between the two groups. Conclusion: This study suggests that laparoscopic hepatectomy for elderly patients with hepatocellular carcinoma may be safe and feasible, with better short-term outcomes and similar long-term outcomes