Meta-analysis of infrahepatic inferior vena cava clamping combined with the pringle maneuver during hepatectomy.

Abstract

This meta-analysis was conducted to evaluate the effectiveness and safety of infrahepatic inferior vena cava clamping combined with the Pringle maneuver during. hepatectomies. Clinical studies were retrieved from the PubMed, Embase, Cochrane Library, Medline and Web of Science databases. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled value using a fixed-effects or random-effects model.Nine studies with 1008 patients in total were included. The infrahepatic inferior vena cava clamping combined with Pringle maneuver group experienced less total operative blood loss (mean difference [MD] = -327.11; 95% CI: -386.50-267.72; P < 0.00001), less blood loss during transection (MD = -270.19; 95% CI: -344.99-195.38; P < 0.00001), fewer blood transfusions (odds ratio [OR] = 0.36; 95% CI: 0.25-0.53;P < 0.00001) and fewer postoperative complications (OR = 0.70; 95% CI: 0.52-0.95; P = 0.02) than did the control group. Operative time (MD = 8.54; 95% CI: 4.68-12.40; P < 0.0001) was similar in both groups. liver transection time,hospital stay, postoperative liver function and renal function did not differ between groups.Applying infrahepatic inferior vena cava clamping combined with the Pringle maneuver can effectively reduce intraoperative bleeding, blood transfusion rates, and postoperative complications, while adding minimal time to the operation.

• Authors: Pan He, Kai He, Furui Zhong, Song Su, Cheng Fang, Shu Qin, Fangyi Pen, Xianming Xia, Bo Li
• Journal: Asian journal of surgery (Asian J Surg) Vol. 44 Issue 1 Pg. 18-25 (Jan 2021) ISSN: 0219-3108 [Electronic] China
• PMID: 32624397 (Publication Type: Journal Article, Meta-Analysis)
• Copyright: Copyright © 2020. Published by Elsevier Taiwan LLC.

Topics

• Adult
• Aged
• Aged, 80 and over
• Blood Loss, Surgical (prevention & control, statistics & numerical data)
• Blood Transfusion (statistics & numerical data)
• Constriction
• Female
• Hepatectomy (methods)
• Humans
• Intraoperative Complications (epidemiology, prevention & control)
• Length of Stay (statistics & numerical data)
• Liver (blood supply)
• Male
• Middle Aged
• Operative Time
• Postoperative Complications (epidemiology, prevention & control)
• Safety
• Treatment Outcome
• Vena Cava, Inferior (surgery)