Safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy:a meta-analysis / 中华肝胆外科杂志

ABSTRACT

Objective To study the safety and effectiveness of infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver during hepatectomy. Methods The databases of PubMed, Cochrane Center, CNKI, VIP, Wan Fang were searched to extract the relevant data for the meta-analysis using the Revmanage 5. 3 software. Results A total of 14 studies with 1595 patients were included in this meta-analysis. The results showed that total bleeding during the combined clamping was significantly lower than that of the Pringle's maneuver alone (MD= -314. 59, 95％CI-362. 37～ -266. 81, P<0. 05). Bleeding during hepatectomy was significantly lower ( MD= -217. 79, 95％ CI -284. 57 ～ -151. 00, P<0. 05); so was the intraoperative blood transfusion rate ( OR = 0. 48, 95％ CI 0. 36 ～ 0. 62, P<0. 05). The incidence of complications was significantly lower (OR =0. 74, 95％ CI 0. 57 ～0. 95, P<0. 05). However, there were no significant differences in operation time, length of hospital stay, intrao-perative monitoring index and postoperative liver and kidney function recovery ( P >0. 05 ) . Conclusions Infra-hepatic inferior vena cava clamping combined with Pringle' s maneuver in hepatectomy was safe and reliable. Compared with the Pringle' s maneuver alone, the combined technique reduce bleeding and the incidence of complications. This technique is worth promoting in clinical practice.