Meta-analysis Of The Effect Of Splenectomy Combined With Pericardial Devascularization On Liver Function And Incidence Of Liver Cancer In Patients With Posthepatitic Cirrhosis

Objective:This study used meta-analysis to evaluate the effect of splenectomy combined with pericardial devascularization on liver function and the incidence of hepatocellular carcinoma(HCC)in patients with post-hepatic cirrhosis(PHC).Patients were treated with splenectomy and pericardial vascular dissection to provide reference data to guide clinical work.Methods:Using a computer comprehensive search PubMed,EMBase,Web of science,Cochrane Library,Sinomed,Articles,VIP,China HowNet database,document retrieval from the start and end time are building a database to October 2018,retrieved PHC patients splenectomy combined cardia Related literature on the clinical efficacy of peripheral vascular disconnection,based on strict quality evaluation and inclusion and exclusion criteria,extract relevant information in the literature,and use Metana15.0 software to conduct meta-analysis of the extracted data,respectively for each group of data.The heterogeneity test was performed,and the effect sizes were combined according to the heterogeneity test results to calculate a 95%confidence interval(CI).Results:A total of 11 case-control studies met the inclusion criteria,with a total sample size of 2681.The results of the meta-analysis of the included case-control study showed that the incidence of splenectomy combined with pericardial vascular dissection and conservative treatment of liver cancer in patients with posthepatitic cirrhosis(OR=0.432,95%CI:0.360～0.519,p<0.001);ALT level before and after surgery(SMD=1.642,95%CI:0.791-2.493,p<0.001);AST level before and after surgery(SMD=0.544),95%CI:-0.302～1.391,p=0.207);ALB level comparison before and after surgery(SMD=-0.870,95%CI:-1.421～-0.319,p=0.002);TBIL level before and after surgery(SMD=0.660),95%CI:0.134～1.185,p=0.014);ALP level before and after surgery(SMD=0.816,95%CI:-0.181～1.814,p=0.109);PT level before and after surgery(SMD=0.746,95%CI:0.288～1.204,p=0.001);WBC level before and after surgery(SMD=-2.893,95%Cl:-3.440～2.046,p<0.001);PLT level before and after surgery(SMD=-4.352,95%CI:-5.379～-3.325,p<0.001).Conclusion:Splenectomy in patients with post-hepatitis cirrhosis can improve liver function and coagulation function and significantly improve the symptoms of hypersplenism,reduce the incidence of liver cancer,and have both therapeutic and preventive effects on patients with cirrhotic portal hypertension.