Partial splenic embolization in treatment of hypersplenism secondary to liver cirrhosis: Meta-analysis / 中国介入影像与治疗学

ABSTRACT

Objective To explore the efficacy of partial splenic embolization (PSE) in the treatment of hypersplenism secondary to liver cirrhosis using Meta-analysis.Methods Randomized control studies,cohort studies and case-control studies concerning the efficacy comparison of PSE and splenectomy in the treatment of hypersplenism secondary to liver cirrhosis were searched on PubMed,Embase,Cochrane Library,Wanfang data,CNKI,Cqvip and CBM for Meta-analysis.The cut-off time for searching was July 25,2015.RevMan software designed by Cochrane cooperation network was used for statistical analysis.The major outcomes indexes were preoperative and postoperative levels of platelet,leukocyte and hemoglobin.The secondary outcomes indexes were operative time,intraoperative bleeding and hospital stay.Results A total of 10 studies were selected.Meta-analysis showed the levels of platelet (mean difference [MD]-87.68,95 ％ CI [-125.70,-49.65]),leukocyte (MD-4.03,95％CI [-5.74,-2.33]) and hemoglobin (MD-0.79,95％CI [-1.48,-0.11]) after PSE treatment were higher than those before,and the levels of platelet (MD-128.31,95％CI [-162.59,-94.03]),leukocyte (MD-5.22,95％CI [-6.65,-3.80]) and hemoglobin (MD-1.42,95％CI [-2.66,-0.18]) after splenectomy were higher than those before the operation.The differences of platelet (MD 54.45,95％CI [37.60,71.30]),leukocyte (MD 1.71,95％CI [-0.01,3.42]) and hemoglobin (MD 0.78,95％CI [-0.01,1.56]) between postoperative and preoperative levels for PSE was lower than those for splenectomy.Compared with splenectomy,PSE exhibited less intraoperative bleeding (MD-71.33,95 ％ CI [-78.13,-64.54]),shorter operative time (MD-34.08,95％CI [-34.78,-33.38]) and shorter length of stay (MD-5.59,95％CI [-7.38,-3.79]).Conclusion PSE is a mini-invasive therapy,which can be used to effectively treat hypersplenism secondary to liver cirrhosis.