Surgical treatment of liver hydatid cyst in elderly patients: A propensity score-matching retrospective cohort study

Acta Trop. 2022 Aug:232:106466. doi: 10.1016/j.actatropica.2022.106466. Epub 2022 Apr 20.

Abstract

Background: Cystic echinococcosis is a clinically complex chronic parasitic disease and a major socioeconomic problem in endemic areas. The safety of liver resection in elderly patients is often debated among medical professionals. We analyzed the postoperative morbidity and mortality rates of elderly patients who underwent surgery at our unit.

Methods: We retrospectively evaluated patients with liver hydatid cysts which were surgically removed at our unit. Patients were divided into two groups: Group 1 (patients < 70 years), and Group 2 (patients ≥ 70 years). Propensity score matching (PSM) and comparative analyses between groups were performed.

Results: The unmatched cohort consisted of 279 patients (Group 1: 244; Group 2: 35). After PSM, we compared the outcomes for 56 patients from Group 1 to 31 patients from Group 2. A higher rate of severe complications was observed in Group 2 (25.8% vs 5.36%, p = 0.014). No difference was found in the rates of infectious, cardiorespiratory, or hemorrhagic complications between both groups, and in the mortality rate either (0.00% vs 6.45%, p = 0.124).

Conclusions: Liver surgery in selected elderly patients is safe and practicable. The low postoperative morbidity rate in these patients is acceptable, albeit higher, due to their comorbidities.

Keywords: Elderly; Liver hydatidosis; Liver surgery; Morbidity.

MeSH terms

  • Aged
  • Echinococcosis*
  • Echinococcosis, Hepatic* / epidemiology
  • Echinococcosis, Hepatic* / surgery
  • Humans
  • Postoperative Complications / epidemiology
  • Propensity Score
  • Retrospective Studies