Postoperative liver function after elective right hepatectomy in elderly patients

Background: Because the influence of age on the risk of liver resection is controversial, the outcome of major liver resection in patients older than 65 years was evaluated. Methods: Between 1990 and 1997, 24 patients aged 65 years or more underwent elective right hepatectomy (segments V-VIII) for a malignant liver tumour arising in a normal liver. They were evaluated retrospectively in terms of operative deaths, morbidity and postoperative liver function, and compared with 22 patients aged 40 years or less who had undergone a similar resection during the same interval. Results: Elective right hepatectomy in patients aged 65 years or more resulted in a similar number of deaths (one versus none) and a similar severe complication rate (12 versus 5 per cent) to that observed in patients aged 40 years or less. Evaluation of liver function on days 2, 5 and 8 after operation, in patients aged 65 years or more and 40 years or less, showed that mean prothrombin time was 52 versus 56 per cent, 58 versus 62 per cent and 76 versus 72 per cent respectively (P not significant) and that the mean total serum bilirubin level was 35 versus 38 mu mol/1, 32 versus 36 mu mol/1 and 25 versus 28 mu mol/1 (P not significant). Postoperative levels of aminotransferases, gamma -glutamyl transpeptidase and alkaline phosphatase were similar in the two groups. Mean(s.d.) duration of hospital stay was 15(7)days in patients aged 65 years or more and 13(4)days in the younger patients. Conclusion: Postoperative liver function after elective right hepatectomy in selected patients older than 65 years was similar to that in younger patients.