Mobarak, Shahd, Stott, Martyn C 
ORCID: 0000-0002-3536-8281, Tarazi, Munir, Varley, Rebecca J, Davé, Madhav S, Baltatzis, Minas and Satyadas, Thomas
(2022)
Selective Hepatic Vascular Exclusion versus Pringle Maneuver in Major Hepatectomy: A Systematic Review and Meta-Analysis.
Frontiers in surgery, 9.
p. 860721.
Abstract
<h4>Objectives</h4>Mortality and morbidity following hepatic resection is significantly affected by major intra-operative blood loss. This systematic review and meta-analysis evaluates whether selective hepatic vascular exclusion (SHVE) compared to a Pringle maneuver in hepatic resection reduces rates of morbidity and mortality.<h4>Methods</h4>A systematic review and meta-analysis were conducted according to the PRISMA guidelines by screening EMBASE, MEDLINE/PubMed, CENTRAL and SCOPUS for comparative studies meeting the inclusion criteria. Pooled odds ratios or mean differences were calculated for outcomes using either fixed- or random-effects models.<h4>Results</h4>Six studies were identified: three randomised controlled trials and three observational studies reporting a total of 2,238 patients. Data synthesis showed significantly decreased rates of mortality, overall complications, blood loss, transfusion requirements, air embolism, liver failure and multi-organ failure in the SHVE group. Rates of hepatic vein rupture, post-operative hemorrhage, operative and warm ischemia time, length of stay in hospital and intensive care unit were not statistically significant between the two groups.<h4>Conclusion</h4>Performing SHVE in major hepatectomy may result in reduced rates of morbidity and mortality when compared to a Pringle maneuver. The results of this meta-analysis are based on studies where tumors were adjacent to major vessels. Further RCTs are required to validate these results.<h4>Clinical trial registration</h4>PROSPERO (CRD42020212372) https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=212372.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | Systematic (Literature) Review, hepatectomy, liver resection, pringle, selective hepatic vascular exclusion (SHVE) |
| Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
| Depositing User: | Symplectic Admin |
| Date Deposited: | 09 Apr 2024 09:55 |
| Last Modified: | 09 Apr 2024 13:52 |
| DOI: | 10.3389/fsurg.2022.860721 |
| Open Access URL: | https://doi.org/10.3389/fsurg.2022.860721 |
| Related URLs: | |
| URI: | https://livrepository.liverpool.ac.uk/id/eprint/3180208 |
Dimensions
Dimensions
