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Title: Portal Pressure Impact on Clinical Outcome after Major Hepatectomy: A Systematic Review and Meta-Analysis
Authors: Maciel Barbosa, Jorge
Tralhão, José Guilherme 
Botelho, Maria Filomena 
Nunes Santos, Jorge
Sousa-Pinto, Bernardo
Abrantes, Ana Margarida 
Gomes Carrapita, Jorge Humberto
Keywords: hepatobiliary surgery; liver; portal venous pressure; portal inflow modulation; posthepatectomy liver failure; meta-analysis
Issue Date: 2020
Serial title, monograph or event: Surgery, Gastroenterology and Oncology
Volume: 25
Issue: 3
Abstract: Aim of the study: To systematically review the evidence regarding the association between portal venous pressure (PVP) after hepatectomy and posthepatectomy liver failure (PLHF) or other postsurgical outcomes. Materials and methods: We searched PubMed, Scopus and Web of Science for studies assessing post-hepatectomy PVP (or its variation) and reporting its association with PHLF or other postsurgical outcomes. We performed a random-effects meta-analysis for the association between development of PHLF and post-hepatectomy PVP and its variation. Heterogeneity was assessed using Q-Cochran test and I2 statistic. Quality assessment was performed considering ROBINS-1 Cochrane tool. Results: Four studies, assessing 439 patients, met the eligibility criteria and were included in this systematic review. The meta-analyses, including 3 studies, demonstrated that patients developing PHLF did not have a significantly higher post-hepatectomy PVP when compared to the remainder (1.98; 95%CI=-1.44-5.39; p=0.256; I2=2%), but had a significantly higher PVP variation (increase) during hepatectomy (1.65; 95%CI=1.15-2.15; p<0.001; I2=0%). The quality of the studies allowed to consider the robustness of the conclusions as “median”. Conclusions: An increased PVP variation following hepatectomy associates with a higher risk of PHLF, but the same was not observed for the absolute value of post-hepatectomy PVP.
ISSN: 2559-723X
DOI: 10.21614/sgo-25-3-113
Rights: openAccess
Appears in Collections:FMUC Medicina - Artigos em Revistas Internacionais
I&D CIBB - Artigos em Revistas Internacionais
I&D ICBR - Artigos em Revistas Internacionais

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