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CN 22-1108/R
Volume 40 Issue 12
Dec.  2024
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Article Navigation >  Journal of Clinical Hepatology  > 2024  >  40(12): 2464-2472

Clinical efficacy of liver venous deprivation versus portal vein embolization in treatment of liver cancer with insufficient residual liver volume： A Meta-analysis

DOI: 10.12449/JCH241217
  • 1.

    The First Clinical Medical College of Shanxi Medical University，Taiyuan 030001，China

  • 2.

    Department of Hepatobiliary and Pancreatic Surgery and Liver Transplant Center，The First Hospital of Shanxi Medical University，Taiyuan 030001，China

Research funding:

Natural Science Foundation of Shanxi Province (201901D111350)

More Information
  • Corresponding author: LIU Hong， lhonglli@sina.cn（ORCID：0009-0000-5304-7134）
  • Received Date: 2024-03-21
  • Accepted Date: 2024-04-22
  • Published Date: 2024-12-25
    Abstract
  •   Objective  To systematically evaluate the efficacy and prognosis of liver venous deprivation （LVD） versus portal vein embolization （PVE） in the treatment of hepatic malignancies with insufficient residual liver volume.  Methods  This study was conducted according to PRISMA guidelines， with a PROSPERO registration number of CRD42024533292. Databases including PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang Data， and VIP were searched for articles on the efficacy of LVD versus PVE. According to the inclusion and exclusion criteria， related articles were screened for quality assessment and extraction of clinical data for LVD and PVE， and related data were summarized and analyzed. RevMan 5.3 was used to perform the Meta-analysis.  Results  A total of 12 articles （all cohort studies） were included， involving 644 patients （245 in the LVD group and 399 in the PVE group）. The Meta-analysis showed that there were significant differences between the two groups in FLR growth rate after embolization （standardized mean difference ［SMD］=0.84， 95% confidence interval ［CI］： 0.59 ‍—‍ ‍1.09， P<0.05）， daily growth volume of FLR after embolization （SMD=1.19， 95%CI： 0.64‍ ‍—‍ ‍1.73， P<0.05）， the incidence rate of complications after embolization （risk ratio ［RR］=1.59， 95%CI： 1.06 ‍—‍ 2.38， P<0.05）， interval between embolization and second-stage surgery （SMD=-0.81， 95%CI： -1.32 to -0.29， P<0.05）， and the completion rate of second-stage surgery （RR=1.09， 95%CI： 1.01 ‍—‍ 1.18， P<0.05）.  Conclusion  Compared with PVE， LVD can enable patients to achieve FLR for surgery in a relatively short period of time， thereby reducing the incidence rate of disease progression， solving the problem of hypertrophic deficiency， achieving a higher second-stage surgical resection rate， and bringing more benefits to patients with liver cancer. In addition， LVD has similar safety profiles to PVE during second-stage surgery.

     

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