Morbidity and mortality after major liver resection in patients with perihilar cholangiocarcinoma: A systematic review and meta-analysis
Morbidity and mortality after major liver resection in patients with perihilar cholangiocarcinoma: A systematic review and meta-analysis
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DOI：
10.1016/j.surg.2019.01.010
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发表时间：
2019-05-01
期刊：
影响因子：
3.8
通讯作者：
van Gulik, Thomas M.
中科院分区：
文献类型：
--
作者：
Franken, Lotte C.;Schreuder, Anne Marthe;van Gulik, Thomas M.
背景：众所周知肝门周围胆管癌切除术后的发病率和死亡率很高。然而，报告的术后结局各不相同，西方和亚洲系列之间存在显著差异。我们的目的是确定肝门周围胆管癌患者肝切除术后的发病率和死亡率，并评估地理位置和医院容量的结果差异。方法：通过检索MEDLINE和EMBASE数据库进行系统评价，截至2017年11月20日。偏倚的风险进行了评估，荟萃分析和荟萃回归进行了使用随机效应model.Results：共纳入51项研究，代表4,634例患者。合并的30天和90天死亡率分别为5%（95% CI 3%-6%）和9%（95% CI 6%-12%）。合并的总体发病率和重度发病率分别为57%（95% CI 50%-64%）和40%（95% CI 34%-47%）。与亚洲研究相比，西方研究的30天死亡率、90天死亡率和总发病率显著更高：8%对2%（P
Background: Morbidity and mortality after hepatectomy for perihilar cholangiocarcinoma are known to be high. However, reported postoperative outcomes vary, with notable differences between Western and Asian series. We aimed to determine morbidity and mortality rates after major hepatectomy in patients with perihilar cholangiocarcinoma and assess differences in outcome regarding geographic location and hospital volume.Methods: A systematic review was performed by searching the MEDLINE and EMBASE databases through November 20, 2017. Risk of bias was assessed and meta-analysis and metaregression were performed using a random effects model.Results: A total of 51 studies were included, representing 4,634 patients. Pooled 30-day and 90-day mortality were 5% (95% CI 3%-6%) and 9% (95% CI 6%-12%), respectively. Pooled overall morbidity and severe morbidity were 57% (95% CI 50%-64%) and 40% (95% CI 34%-47%), respectively. Western studies compared with Asian studies had a significantly higher 30-day mortality, 90-day mortality, and overall morbidity: 8% versus 2% (P