Prevention of non-surgical complications after hepatic resections in the elderly patients

Elderly patients constitute a significant part of patients undergoing liver resection. Non-specific cardio-vascular and pulmonary complications as well as postoperative delirium are common in this group of patients. We analyzed the impact of a standardized perioperative care protocol on the rate of such complications after resections of the liver in patients younger and older than 70 years. Material and methods We analyzed the results of elective liver resections, performed in the Department of Surgical Oncology of the Medical and Rehabilitation Center under the Ministry of Health from 2013 to 2016. There were 122 resection in 99 patients less than 70 years old and 30 procedures in 29 elderly patients. Patients in the elderly group had significantly more cardio-vascular co-morbidities whereas younger patients have had preoperative chemotherapy more often. Results There were no differences regading the extent of liver resection, bloodloss, operating time. Severe morbidity (Clavien-Dindo III-IV grade) developed in 22 and 20% among patients younger and older 70, respectively, mortality was 6 and 7%. Elderly patients developed liver failure more often (13 vs 7%). There were 3 non-specific complications: pneumonia and heart failure in patients younger than 70 years and atrial fibrillation in an elderly patient. Conclusion Standardized protocol of perioperative care in patients undergoing hepatectomy leads to a very low rate of non-specific postoperative complications.