ObjectiveTo assess the effectiveness of hemihepatic vascular occlusion (HHO) and total hepatic inflow occlusion (THO) which were applied in the liver resection.
MethodsRandomized controlled trials (RCTs) comparing HHO and THO in hepatectomy were electro-nically searched from CENTRAL (Issue 1, 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 The English or Chinese version of relevant published and unpublished data and their references were also retrieved by hand. The last retrieval date was in May 2013. The data were extracted and the quality was evaluated by two reviewers independently, and then RevMan 5.2 software was used for data analysis.
ResultsTen RCTs involving 788 patients were finally included. The results of meta-analysis showed that, HHO reduced the levels of aspartate transaminase (AST) (WMD=-235.84, 95%CI-411.28 to-60.40, P=0.008) and alanine aminotransferase (ALT) (WMD=-195.52, 95%CI-351.87 to-39.16, P=0.01) in 1 day postoperatively. HHO also shortened the recovery time of AST (WMD=-3.83, 95%CI-4.52 to-3.15, P < 0.000 01) and ALT (WMD=-4.29, 95%CI-5.75 to-2.84, P < 0.000 01) postoperatively, and shortened the recovery time of gastrointestinal function (WMD=-1.52, 95%CI-2.75 to-0.29, P=0.02). However, HHO was the same as THO in intraoperative haemorrhage and postoperative transfusion and hospital stay.
ConclusionHHO applied in liver resection could relieve the damage of liver function, and shorten the recovery time of gastrointestinal function postoperatively. Due to the poor quality of the included studies, more high quality RCTs with longer follow-up are required to further verify the aforementioned conclusion.
