Postoperative complications following hepatectomy for hepatocellular carcinoma in patients with Child-Pugh B liver function: a systematic review and meta-analysis.

IF 3.3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2026-09-25 DOI:10.1016/j.hpb.2026.09.007

Jiahui Yang, Wenjie Li, Kai Deng, Qingyan Kong, Wei Peng, Zheyu Chen

{"title":"Postoperative complications following hepatectomy for hepatocellular carcinoma in patients with Child-Pugh B liver function: a systematic review and meta-analysis.","authors":"Jiahui Yang, Wenjie Li, Kai Deng, Qingyan Kong, Wei Peng, Zheyu Chen","doi":"10.1016/j.hpb.2026.09.007","DOIUrl":null,"url":null,"abstract":"Background: Liver resection is a curative option for hepatocellular carcinoma (HCC), but its safety in patients with Child-Pugh B cirrhosis remains incompletely defined, and quantitative complication benchmarks are lacking.Methods: This systematic review and single-proportion meta-analysis followed PRISMA Harms guidelines. PubMed, Web of Science, Embase, and Cochrane Library were searched for studies reporting outcomes after curative-intent hepatectomy in Child-Pugh B HCC patients. Pooled proportions were calculated using generalized linear mixed models with logit transformation and random-effects models.Results: 14 studies comprising 1238 patients were included. The pooled overall complication rate (Clavien-Dindo grade I-V) was 38.22% (95% CI, 30.05%-47.12%), and the trim-and-fill adjusted major complication rate (Clavien-Dindo ≥ III) was 14.87% (95% CI, 10.48%-20.67%). The 30-day and 90-day mortality rates were 1.09% (95% CI, 0.20%-5.59%) and 2.56% (95% CI, 1.43%-4.53%), respectively. Surgical approach was a significant moderator of major complications (open 18.18% vs. minimally invasive 7.83%; P = 0.01).Conclusion: These findings provide preliminary quantitative safety estimates that offer a useful reference for clinicians and patients and may help frame shared decision-making at the patient level.","PeriodicalId":13229,"journal":{"name":"Hpb","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hpb","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hpb.2026.09.007","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Liver resection is a curative option for hepatocellular carcinoma (HCC), but its safety in patients with Child-Pugh B cirrhosis remains incompletely defined, and quantitative complication benchmarks are lacking.

Methods: This systematic review and single-proportion meta-analysis followed PRISMA Harms guidelines. PubMed, Web of Science, Embase, and Cochrane Library were searched for studies reporting outcomes after curative-intent hepatectomy in Child-Pugh B HCC patients. Pooled proportions were calculated using generalized linear mixed models with logit transformation and random-effects models.

Results: 14 studies comprising 1238 patients were included. The pooled overall complication rate (Clavien-Dindo grade I-V) was 38.22% (95% CI, 30.05%-47.12%), and the trim-and-fill adjusted major complication rate (Clavien-Dindo ≥ III) was 14.87% (95% CI, 10.48%-20.67%). The 30-day and 90-day mortality rates were 1.09% (95% CI, 0.20%-5.59%) and 2.56% (95% CI, 1.43%-4.53%), respectively. Surgical approach was a significant moderator of major complications (open 18.18% vs. minimally invasive 7.83%; P = 0.01).

Conclusion: These findings provide preliminary quantitative safety estimates that offer a useful reference for clinicians and patients and may help frame shared decision-making at the patient level.

查看原文本刊更多论文

Child-Pugh B肝功能患者肝细胞癌切除术后并发症：系统回顾和荟萃分析

背景：肝切除术是肝细胞癌（HCC）的一种治疗选择，但其在Child-Pugh B肝硬化患者中的安全性仍不完全确定，且缺乏定量的并发症基准。方法：本系统综述和单比例荟萃分析遵循PRISMA Harms指南。PubMed, Web of Science， Embase和Cochrane图书馆检索了报告Child-Pugh B HCC患者治疗目的肝切除术后结果的研究。采用logit变换的广义线性混合模型和随机效应模型计算混合比例。结果：纳入14项研究，1238例患者。合并总并发症发生率（Clavien-Dindo I-V级）为38.22% (95% CI, 30.05% ~ 47.12%)，修整填充调整后的主要并发症发生率（Clavien-Dindo≥III级）为14.87% （95% CI, 10.48% ~ 20.67%）。30天和90天死亡率分别为1.09% （95% CI, 0.20%-5.59%）和2.56% （95% CI, 1.43%-4.53%）。手术入路显著降低了主要并发症（开放18.18% vs微创7.83%;P = 0.01）。结论：这些发现提供了初步的定量安全性评估，为临床医生和患者提供了有用的参考，并可能有助于在患者层面制定共同决策。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).