Introduction : The incidence of intrahepatic cholangiocarcinoma (ICC) in elderly patients is increasing worldwide. Little is known regarding postoperative outcomes in elderly patients undergoing liver resection for ICC.

Methods : 84 patients undergoing liver resection for ICC in single center were identified. Perioperative characteristics, postoperative morbidity, mortality and survival were compared between elderly (60 years, group 1, n=31) and non-elderly (<60 years, group 2, n=53) patients.

Results : Gender (p=0,34), body mass index distribution (p=0,61), duration of stay (p=0,071) were comparable between groups. Group 1 showed predominance of trisectenectomy (41,9% vs 29,4%, p=0,02), group 2 showed predominance of extended hemihepatectomy (19,3% vs 54,7%, p=0,14). Incidence of combined vascular resection and bile duct exploration were 22,5% vs 39,6% (p=0,1) and 32,2% vs 26,4%, (p=0,56) respectively. Operative time (min, 369,8 ± 150,5 vs 375,2 ± 132,1, p=0,04), blood loss (mL, 950,3 ± 670,3 vs 963,2 ± 586,7, p=0,23) were comparable. Incidence of surgical site infections (19,3% vs 18,8%, p=0,95), posthepatectomy liver failure (18,6% vs 22,6%, p=0,47), reoperation (9,6% vs 9,4%, p=0,97) and clinically relevant complications (29,1% vs 32,1%, p=0,77) were comparable. 3‐year OS (29.1% vs 32,5%, p=0,06) and DFS (16,5% vs 18.4%, p=0,004) were comparable between groups.

Conclusions : Liver resection for ICC in elderly patients can obtain acceptable perioperative morbidity rates with a chance of long-term survival