Hemihepatic Inflow Occlusion Versus Total Hepatic Inflow Occlusion In Liver Resection:a Meta-Analysis

Objective:To assess the effectiveness of hemihepatic vascular occlusion (HHO) and total hepatic inflow occlusion (THO) which were applied in the liver resection. Methods:The randomized controlled trials (RCTs) were electro-nically searched from CENTRAL (Issue1,2013), PubMed, EMbase, CBM, CNKI and Digital journals of Chinese medical system. The English or Chinese version of relevant published and unpublished data and their references were also searched by hand. Hepatectomy by HHO or THO were compared in randomized controlled trials. The last retrieval date was on May2013.The data were extracted and the quality was evaluated by two reviewers independently, and the RevMan5.2software was used for data analysis. Results:en studies of RCTs involving788patients were included. The results of meta-analysis showed that, HHO reduced the levels of aspartate transaminase (AST)(WMD=-235.84,95%CI-411.28to-60.48, P=0.008) and alanine aminotransferase (ALT)(WMD=-195.52,95%CI-351.87to-39.16, P=0.01) in1day postoperatively. HHO also shortened the recovery time of AST [WMD=-3.63,95%C1(-4.66,-2.59), P<0.00001] and ALT [WMD=-3.52,95%CI (-4.65,-2.38), P<0.00001] postoperatively, and shortened the recovery time of gastrointestinal function [WMD=-0.92,95%CI (-1.30,-0.55),P<0.00001] However, HHO was the same as THO in intraoperative hemorrhage (WMD=-2.86,95%CI-54.17to48.46, P=0.91). Conclusion:HHO applied in liver resection could reduce the damage of liver function, and shorten the recovery time of gastrointestinal function postoperatively. Due to the low quality of the included studies, more high quality RCTs with longer follow-up are required to further verify the aforementioned conclusion.