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Effectiveness of Terlipressin on Modulation of Portal Vein Pressure after Hepatic Resections in Non-Cirrhotic Patients. A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Authors :
Nicola de Angelis
Paschalis Gavriilidis
Madhava Pai
Keith J. Roberts
Alan Askari
Riccardo Memeo
Robert P. Sutcliffe
Salomone Di Saverio
Source :
Chirurgia. 115:707
Publication Year :
2020
Publisher :
Celsius Publishing House, 2020.

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.

Details

ISSN :
12219118
Volume :
115
Database :
OpenAIRE
Journal :
Chirurgia
Accession number :
edsair.doi.dedup.....1d35fd84164b3b0a4e62d50814b61f77
Full Text :
https://doi.org/10.21614/chirurgia.115.6.707