Abstract: Objective To determinate the risk factors of postoperative pulmonary complications(PPCs) after hepatic resection for elderly patients and explore the precise perioperative managements. Method The clinical data of  114 elderly patients who underwent hepatectomy in our  hospital between January 2016 and December 2020 were collected.They were divided into PPCs group and control group according to occurrence of PPCs,and statistical analysis was conducted to explore the relevant factors that could affect the occurrence of postoperative pulmonary complications after liver resection in elderly patients.Results 114 elderly patients with liver resections were included.Postoperative pulmonary complications occurred in 36(31.6%,PPCs≥1) patients,including 1 ARDS,10 atelectasis,19 pleural effusions,and 26 pneumonias.Univariate analysis showed that PPCs were statistically different between the age of patients,smoking history,and pulmonary comorbidities before surgery,and were related to the type of liver resection,duration of surgery,and intraoperative blood loss(P＜0.05).Logistic regression analysis showed that the age of patients,smoking history,preoperative pulmonary comorbidities,operation duration and intraoperative blood loss were the independent risk factors for PPCs after hepatectomy in the elderly patients(P＜0.05). Conclusion Age,smoking history,preoperative pulmonary comorbidities,duration of operation,and intraoperative blood loss were the risk factors for pulmonary complications after hepatectomy in the elderly patients.Evaluation could help to select appropriate treatment and perioperative management for the elderly patients with hepatectomy.

Key words: elderly patient, Hepatectomy, postoperative pulmonary complications, risk factors