Immediate and distant results of liver and bile duct resections for portal cholangiocarcinoma in elderly and senile patients

Aim. Evaluation of surgical outcomes in elderly and senile patients with portal cholangiocarcinoma.

Materials and methods. The immediate and long-term results of surgical treatment of 170 patients with portal cholangiocarcinoma performed in 2013–2023 were analyzed. A comparison of the outcomes in patients aged below 60, 60–74, and over 74 years old was carried out. Factors prognostically associated with a high risk of fatal outcome in elderly and senile patients were determined by multivariate logistic regression analysis.

Results. The senile patient group was more likely to develop severe complications (p = 0.089) and had a higher 90-day mortality (p = 0.042). The combination of such factors as the Charlson comorbidity index, Comprehensive Risk Score (CRS), resection volume, and surgery duration showed high prognostic significance with respect to hospital mortality, with an area under the ROC curve (AUC) of 0.895 (p < 0.001). The overall and recurrence-free survival of patients did not differ among all age groups (p = 0.886).

Conclusion. In the absence of appropriate patient selection based on risk factors, the surgical outcomes in senile patients deteriorate. When planning a surgical intervention in senile patients, attention should be paid to minimizing surgical trauma and surgery duration, especially in patients with a high comorbidity index.

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