Major Liver Resections for Primary Liver Malignancies in the Elderly

Sgourakis, George; Sotiropoulos, G.C.; Bockhorn, Maximilian; Fouzas, I.; Radtke, Arnold; Molmenti, Ernesto P.; Drühe, N.; Broelsch, C. E.; Karaliotas, Constantine; Lang, Hauke

doi:10.1080/00015458.2009.11680436

Cited by 10 publications

(16 citation statements)

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“…The significant factors shown to have an influence on the discharge disposition are age, pre‐operative co‐morbidities and length of stay. Several reports have demonstrated the safety of hepatic resection in the elderly 13–15 . These reports documented mortality and morbidity rates that were similar to younger patients 13–15 .…”

Section: Discussionmentioning

confidence: 88%

National trends in discharge disposition after hepatic resection for malignancy

Shah

Ullrich

Smith

et al. 2011

HPB

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Section: Discussionmentioning

confidence: 88%

National trends in discharge disposition after hepatic resection for malignancy

Shah

Ullrich

Smith

et al. 2011

HPB

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“…With the current improvements in surgical techniques and perioperative care, major hepatic resection for HCC, mainly in the form of classical right or left hepatectomy, is associated with acceptable operative morbidity and mortality in selected patients with cirrhosis [11,26,27]. Some studies also demonstrate that major hepatectomy can be performed as safely in elderly patients as in younger patients [5,15,16,28]. However, there is a paucity of data in the literature on major resection for HCC in cirrhotic elderly patients.…”

Section: Discussionmentioning

confidence: 96%

“…These changes may contribute to the reduced hepatic regenerative capacity in the elderly [14], and this may compound the risk associated with major hepatectomy and advanced age. It has been reported that liver resections for HCC and colorectal liver metastases are as safe in the elderly as those in younger patients [5,15,16]. However, few studies have focused on the outcomes after major hepatectomy (resection of three or more Couinaud segments) in patients with liver cirrhosis aged over 70 years.…”

Section: Introductionmentioning

confidence: 97%

Major hepatectomy is safe for hepatocellular carcinoma in elderly patients with cirrhosis

Wang

Zhu²,

Cheng³

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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With rigorous screening of patients and improvement of perioperative management and operative techniques, major hepatectomy can be safely performed on HCC patients aged 70 years or more with liver cirrhosis. Intraoperative red blood cell transfusion of 5 U or more was predictive of higher morbidity in the elderly. Surgeons should take care to minimize the likelihood of intraoperative blood transfusion in elderly patients.

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“…The morbidity after major liver resections is 20%-50%, depending on the general status of the patient during the op- eration, the presence of an underlying disease, and the size of the resection (6,7). In the literature, biliary fistula, sepsis, and infection have been described as the major complications of ALPPS during the postoperative period (3).…”

Section: Discussionmentioning

confidence: 99%

Portal vein ligation and in situ liver splitting in metastatic liver cancer

et al. 2018

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Portal vein ligation and in situ liver splitting in metastatic liver cancerThe most serious complication after major liver resection is liver failure. Depending on preoperative liver function, a future liver remnant of 25%-40% is considered sufficient to avoid postoperative liver failure. A new technique known as portal vein ligation combined with in situ splitting has been developed to obtain rapid liver hypertrophy. Herein, we present a case where we performed portal vein ligation combined with in situ splitting. A 37-year-old male patient with a diagnosis of sigmoid adenocarcinoma and liver metastasis underwent anterior resection because of an obstructing sigmoid tumor and received palliative chemotherapy. After chemotherapy, abdominal computed tomography revealed a lesion, 50 mm in diameter, localized between segments 5-8 of the liver on the bifurcation of the anteroposterior segmental branch of the right portal vein. Computed tomography volumetric assessments of the liver were performed in the preoperative period, and it was found that the remnant left liver volume was less than 25%. In the first stage, portal vein ligation and in situ splitting of the liver parenchyma were performed. On the second and sixth postoperative days, computed tomography revealed hypertrophy of the left liver lobe. On the sixth day, a right hepatectomy was performed. Portal vein ligation combined with in situ splitting has been used by surgeons worldwide to obtain rapid and adequate liver hypertrophy. This new approach yields hope for patients with locally advanced liver tumors and may increase the number of curative resections for primary or metastatic liver tumors.

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Major Liver Resections for Primary Liver Malignancies in the Elderly

Abstract: Advanced age does not seem to negatively affect the outcome of liver resections for malignancies. Hepatic resections in patients 75 years of age or older may be carried out with relative safety as long as patients are appropriately selected.

Cited by 10 publications

References 0 publications

National trends in discharge disposition after hepatic resection for malignancy

National trends in discharge disposition after hepatic resection for malignancy

Major hepatectomy is safe for hepatocellular carcinoma in elderly patients with cirrhosis

Portal vein ligation and in situ liver splitting in metastatic liver cancer

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