Abstract:

[Abstract] Objective  To evaluate the clinical value of the single dose glucocorticoid before liver resection using meta analysis. Methods  Randomized controlled trials (RCTs) focused on preoperative single dose glucocorticoid in liver resection were identified from Pubmed, Medline, Embase, the Cochrane Library, Chinese Biomedical Literature Database (CBM), VIP database, and Wanfang database according to the inclusion and exclusion criteria. All relevant studies were screened and the data were extracted by two independent reviewers.The qualities of the included studies were evaluated by modified Jadad score. Meta analysis was processed by RevMan 5.1. Results Five randomized controlled trials were included in this analysis. These studies included a total of 222 patients. The methodological quality was evaluated and all of the trials were in high quality. The meta analysis revealed that the postoperative peak of interleukin (IL)-6 value［MD=-53.70；95% CI (-74.11--33.29)；P < 0.01］, peak value of total bilirubin (TBIL)［MD=-13.77；95%CI (-23.77--3.78)；P < 0.01］, postopera? tive complications[OR=0.30；95%CI (0.16-0.57)；P < 0.01]and the length of hospital stay［MD=-2.91；95%CI(-4.55--1.28)； P < 0.01］were significantly decreased in glucocorticoid group than those in control group. There were no statistical differences in the peak alanine aminotransferase (ALT) value and peak aspartic transaminase (AST) value between the two groups after operation (P > 0.05). Conclusion  These results suggest that the preoperative single dose glucocorticoid could reduce the release of inflammatory cytokines and improve the outcomes in patients undergoing liver resection. Its efficacy on liver function and ischemia-reperfusion (I/R) injury needs further investigation.

Key words: hepatectomy, glucocorticoids, interleukin-6, alanine transaminase, aspartate aminotransferases, bilirubin, reperfusion injury, Meta分析