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Meta-Analysis
. 2014 Jan;16(1):12-9.
doi: 10.1111/hpb.12066. Epub 2013 Mar 6.

Use of pre-operative steroids in liver resection: a systematic review and meta-analysis

Arthur J Richardson  1 , Jerome M Laurence, Vincent W T Lam
Affiliations
Meta-Analysis

Use of pre-operative steroids in liver resection: a systematic review and meta-analysis

Arthur J Richardson et al. HPB (Oxford). 2014 Jan.

Abstract

Background: By attenuating the systemic inflammatory response to major surgery, the pre-operative administration of steroids may reduce the incidence of complications.

Methods: A systematic review was conducted to identify randomized controlled trials (RCT) comparing pre-operative steroid administration with placebo during a liver resection. Meta-analyses were performed.

Results: Five RCTs were identified including a total of 379 patients. Pre-operative steroids were associated with statistically significant reductions in the levels of serum bilirubin and interleukin 6 (IL-6) on post-operative day one. There was a trend towards a lower incidence of post-operative complications and prothrombin time (PT), but this did not reach statistical significance.

Conclusion: Pre-operative steroids may be associated with a clinically significant benefit in liver resection.

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Figures

Figure 1
Figure 1
Flow chart showing the search strategy used to identify studies. RCT, randomized controlled trial
Figure 2
Figure 2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study
Figure 3
Figure 3
Forest plots illustrating meta-analysis of outcomes in patients undergoing a liver resection with pre-operative steroid administration (steroids) or placebo (control). The outcomes analysed were post-operative complications (a), length of stay (b), serum bilirubin (c), prothrombin time (d) and IL-6 on postoperative day 1 (e). M-H, Mantel-Haenszel; 95% CI, 95% confidence
See this image and copyright information in PMC

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