Effect of hemihepatic vascular exclusion versus total hepatic vascular exclusion in hepatectomy for primary liver cancer: A Meta-analysis / 临床肝胆病杂志

ABSTRACT

ObjectiveTo systematically evaluate the effect of Pringle’s measure (PM) versus hemihepatic vascular occlusion (HVO) in hepatectomy for primary liver cancer. MethodsRelated Chinese and English databases were searched for control studies on HVI versus PM in the treatment of primary liver cancer published up to June 2020. After quality evaluation and data extraction of the included studies, RevMan5.3 software was used for the meta-analysis. ResultsA total of 10 studies were included in the Meta-analysis, with 1272 patients in total. On days 1 and 3 after surgery, the HVO group had a significantly lower level of alanine aminotransferase than the PM group (day 1 mean difference ［MD］=-172.71, 95% confidence interval ［CI］ -289.26 to -56.16, P=0.004; day 3 MD=-130.35, 95%CI -221.25 to -39.45, P=0.005). On day 3 after surgery, the HVO group had a significantly lower level of aspartate aminotransferase than the PM group (MD=-84.56, 95%CI -166.47 to -2.65, P=0.04), and on days 1 and 3 after surgery, the HVO group had a significantly higher level of albumin than the PM group (day 1 MD=1.31, 95%CI 0.06-2.56, P=0.04; day 3 MD=1.81, 95%CI 027-335, P=0.02). The HVO group had a significantly longer time of operation than the PM group (MD=8.95, 95%CI 4.30-13.60, P＜0.01). ConclusionHVO is a safe and effective method for vascular occlusion, and compared with PM, it can effectively alleviate liver injury. However, surgeons should select a suitable method for occlusion based on their own personal experience, patients’ conditions, and specific situation during surgery.