Systematic review and Meta-analysis of feasibility and safety of associating liver partition and portal vein ligation for staged hepatectomy / 国际外科学杂志

ABSTRACT

Objective To assess the feasibility and safety between ALPPS and two-stage hepatectomy (TSH).Methods An electronic search was performed of the MEDLINE,EMBASE using subject heading to identify nearly three-years articles published that related to this topic.Pooled odds ratio was calculated for binary data and mean differences for continuous outcomes,using fixed-effects and random-effects models for meta-analysis.Results Four studies involving a total of 312 patients were used in the analysis.We found that ALPPS produced a higher increase rate of FLR than TSH (MD =24.78;95％CI0.63 to 48.94;P =0.04).Comparing with TSH,ALPPS produced a shorter FLR growth time (MD =-26.55;95％ CI-37.13 to -15.97,P ＜ 0.05).There was no statistical significance in overall mortality (OR =2.43;95 ％ CI0.94 to 6.31;P =0.07),while ALPPS produced a more severe complication rate (≥ Ⅲ b) than TSH (OR =2.47;95 ％ CI1.14 to 5.36;P =0.02).Conclusions It was better to make the FLR increasing to safe resection for ALPPS than TSH in a short period of time.There was no statistical significance in overall complication and mortality between ALPPS and TSH,but ALPPS produced more severe complication rate (≥ Ⅲb) than TSH.