Liver resection, or pancreaticoduodenectomy, among the elderly, is considered to be associated with high morbidity and mortality rates traditionally.

Advances in surgical and anesthetic techniques, a surge in elderly patients, and an increasing need to justify the use of limited health care resources prompted Garden O.J. to assess recent surgical outcomes.

The researcher utilized data from 577 liver resections (July 1985–July 1994) performed for metastatic colorectal cancer and 488 pancreatic resections (October 1983–July 1994) performed for pancreatic malignancies. The observations of the study were as follows-

• 128 patients of age =/>70 years with Liver resection demonstrated a 4% perioperative mortality rate and a 42% complication rate. 
• Median hospital stay was 13 days, and admission to the intensive care unit (ICU) was needed in 8% of the patients. 
• Median survival was found to be 40 months.
• The 5-year survival rate was found to be 35% in elderly patients
• Results of patients <70 years of age and patients of =/>70 years of age, who had undergone liver resection were similar; However, the younger patients had a minimally shorter hospital stay.
• 138 patients of age =/>70 years with Pancreatic resection demonstrated a mortality rate of 6% and a complication rate of 45%. 
• Median hospital stay was 20 days, and admission to the intensive care unit (ICU) was needed in 19% of the patients, these were similar with the younger cohort. 
• Long-term survival was found to be poorer in the elderly patients 
• 5-year survival rate was found to be 21% in the elderly compared to 29% in the younger cohort.

Thus, major liver or pancreatic resections were rendered suitable for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Moreover, Chronologic age alone should not be a contraindication to the liver or pancreatic resection for malignancy.

Source: O. J. Garden. Liver and Pancreatic Resection in the Elderly, HPB Surgery, 1997;10. https://doi.org/10.1155/1997/84160