SURGERY IN ELDERLY PATIENTS IN MEXICO - PORTAL-HYPERTENSION SURGERY AS AN EXAMPLE

Although people older than 65 years represent less than 5% of Mexico's registered population, medical care for elderly patients requires a m ultidisciplinary approach. In our academic university hospital, they a re managed by a team of specialists. As an example of this approach, w e evaluated the surgical treatment of bleeding portal hypertension in a highly selected elderly population. A retrospective study was done r eviewing the files of 25 patients older than 65 years. All had good li ver function (Child-Pugh class A and B) and had undergone elective sur gery. Sixteen of them were women. The mean age was 68.8 years (age ran ge, 65-76 years), and most had a diagnosis of cirrhosis. All patients were treated with portal blood flow-preserving procedures (selective s hunts or Sugiura-Futagawa procedures). The operative mortality was 8%. Eight later deaths were recorded, with a mean follow-up of 25 months (range, 2-110 months). Survival (Kaplan-Meier) was 87% at 12 months, 5 4% at 60 months, and 45% at 110 months. Two rebleeding incidents were recorded as well as 3 cases of postoperative encephalopathy. We conclu ded that well-selected elderly patients, undergoing elective surgery w ith portal blood flow-preserving procedures, have a good postoperative outcome.