Abstract：
Background-Objectives: It has been reported, that high posthepatectomy portal vein pressure (PVP) has deleterious effect on the liver parenchyma and causes posthepatectomy liver failure (PHLF) and increased 90-day mortality. Terlipressin, is widely used to mitigate the effects of portal hyper-tension. Randomised clinical trials (RCTs) demonstrated encouraging results of use of terlipressin for modulation of increased posthepatectomy PVP. The aim of the present study was to evaluate the effectiveness of the pharmacological modulation of the increased posthepatectomy PVP after major hepatectomy. Methods: Systematic literature searches of electronic databases in accordance with PRISMA was conducted. Meta-analysis was conducted using both fixed- and random-effects models. Results: Three randomised controlled trials (RCTs) comparing terlipressin versus placebo including 284 patients of pooled 60 studies were selected. Placebo cohort patients were significantly younger by 5 years compared to terlipressin cohort. However, the terlipressin cohort demonstrated significantly shorter intensive care unit (ICU) stay compared to placebo cohort. Conclusions: The first meta-analysis demonstrated that terlipressin cohort patients although significantly older by 5 years had significantly shorter ICU stay compared to placebo cohort. Furthermore, though statistically nonsignificant only 6% of terlipressin patients needed inotropic support compared to 16.4% of placebo cohort.
摘要：
背景目标：据报道，高术后门静脉压力(PVP)对肝实质有有害影响,导致术后肝衰竭(PHLF)和90天死亡率增加。特利加压素,广泛用于减轻门静脉高压的影响。随机临床试验（RCT）证明了使用特利加压素调节术后PVP增加的令人鼓舞的结果。本研究的目的是评估肝切除术后增加的PVP的药理调制的有效性。方法：根据PRISMA对电子数据库进行系统的文献检索。使用固定效应和随机效应模型进行Meta分析。结果：选择了三项比较特利加压素与安慰剂的随机对照试验（RCT），包括60项研究的284名患者。安慰剂队列患者与特利加压素队列相比显著年轻5年。然而,特利加压素队列显示,与安慰剂队列相比,重症监护病房(ICU)住院时间显著缩短.结论：首次荟萃分析表明，与安慰剂队列相比，特利加压素队列患者尽管年龄明显超过5岁，但ICU住院时间明显缩短。此外，尽管统计学上无显著性差异,但只有6%的特利加压素患者需要正性肌力支持,而安慰剂队列为16.4%.
