关键词: 肝切除, 钳夹法, 荟萃分析

Abstract:

Meta-analysis of of evaluation various technigues of evaluation various technigues of liver parenchymal transection        XIE Sheng-xue*, CHEN Jiang-ming, LIU Fu-bao, et al. *The Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China
Corresponding author: GENG Xiao-ping, E-mail: xp_geng@163.net
Abstract    Objective    To evaluate efficacy of the clamp-crushing technique versus other transection techniques during liver surgery. Methods    Randomized controlled trials (RCTs) comparing the clamp-crushing technique and other method of hepatic transection that were published before June 2014 were retrieved and subjected to this systematic review and Meta-analysis. Results    Twelve RCTs evaluating 1039 patients were included in this Meta-analysis. No significant difference was observed between the clamp-crushing and other transection techniques in the incidence of overall morbidity (RR=0.99, 95%CI: 0.84-1.17, P=0.91), biliary leakage (RR=1.02, 95%CI: 0.70-1.49, P=0.91), mortality (RR=2.16, 95%CI: 0.84-5.58, P=0.11) and transfusion rates (RR=1.25, 95%CI: 0.96-1.63, P=0.10). None of the identified RCTs demonstrated a clinically important benefit of other transection technique in terms of operative time, parenchymal injury, blood loss and hospital stay, except one RCTs showed the RF-LR group had significantly reduced total intraoperative blood loss and another RCTs showed the Ligsure group had significantly reduced hospital stay. Conclusions    Any alternative transection technique did not exhibit any significant advantage over the clamp-crushing. The Clamp-crush technique is advocated as the method of choice in elective hepatic resection.

Key words: hepatectomy, clamp-crush technique, Meta-analysis