A Meta-analysis Of Compare Associating Liver Partition With Portal Vein Ligation For Staged Hepatectomy(ALPPS) With Portal Vein Embolization

This meta-analysis aimed to review the efficacy of associating liver partiton with portal vein ligation for staged hepatectomy(ALPPS) and compare with portal Vein embolization(PVE).A web search was performed in "Pubmed", "Embase", "Corchrane library" and "CNKI" databases using both subject headings and truncated word to identify all the articles published that related to this topic.Pooled risk ratios were calculated for categorical variables and mean differences for continuous variables using the fixed-effects and random-effects models for meta analysis.Six studies involved 394 patients, of whom 78 were in the ALPPS group and 316 in the PVE group. Morbidity was experienced in 42.6% patients in the ALPPS group and39.6% in the PVE group(OR:1.15,95%CI 0.68-1.94,Z=0.53,P=0.6).Mortilaty rate:ALPPS group 6%,PVE group 4%(OR=2.0,95%CI,0.69-5.81,P=0.21).Second surgeries were performed successfully in 100% patients in ALPPS group and 84.5% in the PVE group(OR:7.85,95%CI 1.89-32.6,Z=2.83,P=0.005).The mean regeneration rate of FLR in the ALPPS group was 59% compared with 46.5% in the PVE group(MD=19.45,95%CI,5.19-33.71,Z=2.67,p=0.008).So from the outcome of this meta-analysis, ALPPS is effectively and safety.