SP 7.11 Postoperative Outcomes Following Liver Resection in Octogenarian and Non-Octogenarian Patients: A Systematic Review and Meta-Analysis

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Aims To compare postoperative outcomes between octogenarian (≥80 years) and non-octogenarian (<80 years) patients undergoing liver resection. Methods A systematic review and meta-analysis of 23 retrospective observational studies was performed, including 48,509 patients (3,705 octogenarians and 44,804 non-octogenarians). Primary outcomes were total complications and mortality (in-hospital, 30-day, and 90-day). Total complications included both surgical and medical events such as thromboembolic events, pneumonia, pleural effusion, sepsis, cardiac complications, renal dysfunction, and other systemic complications. Secondary outcomes included surgical complications, surgical wound infection, intra-abdominal infection, haemorrhage, and bile leak. Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using a Mantel–Haenszel random-effects model. Results Octogenarians had significantly higher total complication rates compared with non-octogenarians (OR 1.90, 95% CI 1.33–2.73, p = 0.0004). However, surgical complication rates were comparable between groups (OR 0.93, p = 0.79). In-hospital (OR 2.14, p = 0.03), 30-day (OR 1.52, p = 0.004), and 90-day mortality (OR 2.08, p = 0.004) were significantly higher in octogenarians, while overall mortality showed no significant difference (OR 1.11, p = 0.72). No significant differences were observed in wound infection, intra-abdominal infection, haemorrhage, or bile leak (p > 0.05). Conclusions While surgical complication rates following liver resection are comparable between octogenarian and younger patients, total complications and short-term mortality are higher in the elderly, largely driven by medical complications related to age, frailty, and comorbidities rather than surgical factors. Careful perioperative optimisation and patient selection remain essential when offering hepatic resection to this group.