Meta Analysis Of Risk Factors For Liver Failure After Hepatectomy In Patients With Hepatocellularcarcinoma

Objective To explore the risk factors of liver failure in patients with hepatocellular carcinoma after hepatectomy, and provide a theoretical basis in predicting and preventing the postoperative liver dysfunction.Methods Meta analysis was used in articles on risk factors of the national postoperative liver failure in patients with hepatocellular carcinoma published in China from January 1990 to May 2014, by searching the databases of SinoMed vip cnki wanfang in computer, Supplemented by manual retrievalling.Results The incidence of postoperative liver failure was no significant difference between the male group and female group, between the group with hepatic vascular exclusion and the group without hepatic vascular exclusion. PHLF was significantly lower (combined OR=6.28 95%CI: 4.55-8.65) in patients of Child-Pugh A; The incidence of PHLF was higher in the group with the prealbumin less than 170mg/dl,the difference was statistically significant(combined OR=4.96 95%CI:3.03-8.10);In the PHLF group and healing group, the cirrhosis of liver had the significant difference(combined OR=4.14 95%CI:2.46～6.98);The incidence of PHLF was significantly lower in the group whose blood loss was less than 1000ml(combined OR=5.62 95%CI:3.46～9.11);The diameter of tumor lesser than 10cm(combined OR=2.69 95%CI:1.58～4.57) and the excision extension lesser than hemihepatectomy had lower PHLF rate than the corresponding control group, which has statistically difference(combined OR=1.64 95%CI:1.12～2.40).The incidence of PHLF was increased in the group more than 60 years(combined OR=1.73 95%CI:1.25～2.39) as well as in blood transfusion group(combined OR=3.79 95%CI:2.20～6.51).Conclusion Liver failure after hepatectomy with hepatocellular carcinoma had no relationship with gender and hepatic vascular exclusion. Age, Preoperative prealbumin, cirrhosis, Child-Pugh, blood loss, diameter of tumor, excision extension, blood transfusion are factors influencing the risk of postoperative liver dysfunction.