Efficacy of Probiotics and Prebiotics in Prevention of Infectious Complications Following Hepatic Resections: Systematic Review and Meta-Analysis.

Abstract

BACKGROUND AND AIMS:

Infections occurring after hepatic resection cause significant morbidity, mortality, and prolonged hospitalization. Probiotics and prebiotics are considered to offer protection against post-operative infections. We aimed to determine the effect of probiotics and prebiotics on the post-operative infection rate after hepatic resection by conducting a systematic review and a meta-analysis.

METHOD:

We searched various databases, namely, the PubMed, Medline, Embase, and Cochrane Controlled Trials Registry (CENTRAL), for randomized controlled trials evaluating the effect of probiotics and/or prebiotics on the infection rate following hepatic resection. Extracted data were pooled and subsequently used in a meta-analysis with a random-effects model. Review was reported following the PRISMA guidelines.

RESULTS:

A total of 4 studies comprising 205 patients were included for our meta-analysis. The infection rates in the probiotic group and placebo group were 11.7% and 30.3%, respectively (p<0.001). The pooled risk ratio (RR) was 0.41 (95% confidence interval [CI]: 0.128-0.730). Subgroup analysis indicated that the wound infection rate in the probiotic group (5.3%) was significantly lower than that in the placebo group (RR: 0.387, 95% CI: 0.155-0.970, p=0.043). Furthermore, probiotics/prebiotics decreased the duration of hospital stay (-0.57 days; 95% CI: -0.861 to -0.274; p<0.001) and antibiotic use (mean difference: -3.89 days, 95% CI: -4.17 to -3.60; p<0.001). There was no significant statistical heterogeneity.

CONCLUSION:

Our findings show that administration of probiotics and/or prebiotics prior to operation day decreases the infection rate post-liver resection and could shorten the duration of hospitalization and antibiotics use.

• Authors: Yu Gan, Song Su, Bo Li, Chen Fang
• Journal: Journal of gastrointestinal and liver diseases : JGLD (J Gastrointestin Liver Dis) Vol. 28 Pg. 205-211 (Jun 01 2019) ISSN: 1842-1121 [Electronic] Romania
• PMID: 31204407 (Publication Type: Meta-Analysis, Systematic Review)

Chemical References

• Anti-Bacterial Agents
• Prebiotics

Topics

• Anti-Bacterial Agents (administration & dosage)
• Bacterial Infections (prevention & control)
• Bias
• Drug Administration Schedule
• Hepatectomy
• Humans
• Length of Stay (statistics & numerical data)
• Liver Neoplasms (surgery)
• Postoperative Complications (prevention & control)
• Prebiotics
• Preoperative Care (methods)
• Probiotics (therapeutic use)
• Randomized Controlled Trials as Topic (methods)