Evaluating Laparoscopic and Robotic Liver Resection in Elderly Patients: A NSQIP Analysis of Short-Term Outcomes.

Results of minimally invasive laparoscopic (LLR) and robotic liver resection (RLR) have been promising, but the benefits in the elderly patients are still unclear. This study aims to compare short-term outcomes of LLR and RLR in elderly patients. The 2017-2021 NSQIP database was analyzed comparing patients ≥ 65 years old undergoing LLR versus RLR. Postoperative outcomes, factors associated with complications and mortality were assessed using propensity score matched (PSM) and multivariable logistic regression. We analyzed 2,210 patients undergoing LLR (n = 1865,84.4%) and RLR (n = 345,15.6%). Patients undergoing LLR were older (72.4 vs. 71.8 years; p = 0.04) and more likely to have ASA 4 (11.1% vs. 4.9%; p = 0.001). RLR patients had shorter hospital stays (3.5 vs. 4.4 days; p < 0.001) but longer operative durations (221.4 vs. 203.5 min; p = 0.013). On adjusted analyses, RLR was not associated with increased odds of serious complications (OR: 0.82, CI95% 0.42-1.58, p = 0.545) or mortality (OR: 0.87, p = 0.851). After PSM, RLR statistically reduced length of stay (-0.72 days; p = 0.012) but increased operative times ( + 32.62 min; p < 0.001). Subgroup analysis of patients ≥ 75 years confirmed consistent findings. RLR provides comparable safety and short-term outcomes to LLR, offering shorter hospital stays but longer operative durations. Findings support RLR as a viable option in elderly patients, but further studies evaluating long-term outcomes are warranted.