Document Detail


Hemihepatic versus total hepatic inflow occlusion during hepatectomy: a systematic review and meta-analysis.
MedLine Citation:
PMID:  21912460     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate the clinical outcomes of patients undergoing hepatectomy with hemihepatic vascular occlusion (HHO) compared with total hepatic inflow occlusion (THO).
METHODS: Randomized controlled trials (RCTs) comparing hemihepatic vascular occlusion and total hepatic inflow occlusion were included by a systematic literature search. Two authors independently assessed the trials for inclusion and extracted the data. A meta-analysis was conducted to estimate blood loss, transfusion requirement, and liver injury based on the levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Either the fixed effects model or random effects model was used.
RESULTS: Four RCTs including 338 patients met the predefined inclusion criteria. A total of 167 patients were treated with THO and 171 with HHO. Meta-analysis of AST levels on postoperative day 1 indicated higher levels in the THO group with weighted mean difference (WMD) 342.27; 95% confidence intervals (CI) 217.28-467.26; P = 0.00 001; I(2) = 16%. Meta-analysis showed no significant difference between THO group and HHO group on blood loss, transfusion requirement, mortality, morbidity, operating time, ischemic duration, hospital stay, ALT levels on postoperative day 1, 3 and 7 and AST levels on postoperative day 3 and 7.
CONCLUSION: Hemihepatic vascular occlusion does not offer satisfying benefit to the patients undergoing hepatic resection. However, they have less liver injury after liver resections.
Authors:
Hai-Qing Wang; Jia-Yin Yang; Lu-Nan Yan
Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  17     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-09-13     Completed Date:  2011-12-19     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  3158-64     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aspartate Aminotransferases / metabolism
Blood Loss, Surgical
Hepatectomy / methods*
Humans
Liver / blood supply*,  surgery*
Randomized Controlled Trials as Topic
Treatment Outcome
Chemical
Reg. No./Substance:
EC 2.6.1.1/Aspartate Aminotransferases
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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