Z Gastroenterol 2017; 55(08): e57-e299
DOI: 10.1055/s-0037-1605097
Kurzvorträge
Leber und Galle
Prognostische Faktoren für Leberzirrhose und Acute on chronic liver failure: Donnerstag, 14 September 2017, 12:55 – 14:23, Rotterdam/Forschungsforum 2
Georg Thieme Verlag KG Stuttgart · New York

Predictive role of low perioperative platelet count on posthepatectomy liver failure and mortality: a systematic review and meta-analysis

M Golriz
1   Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Deutschland
,
O Ghamarnejad
1   Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Deutschland
,
E Khajeh
1   Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Deutschland
,
K Hoffmann
1   Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Deutschland
,
A Mehrabi
1   Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Deutschland
› Author Affiliations
Further Information

Publication History

Publication Date:
02 August 2017 (online)

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Background:

Despite remarkable advances in liver surgery, posthepatectomy liver failure (PHLF) and mortality remain challenging issues, especially following extended hepatectomy. To predict these conditions, some authors have recently focused on the potential of perioperative platelet count (PLT).

Aim:

Evaluating the impact of perioperative PLT on PHLF and mortality following hepatectomy based on a systematic review and meta-analysis.

Methods:

A systematic literature search was performed using PubMed and Web of Science. All studies comparing patients with perioperative low and high PLT with outcomes of PHLF or mortality were included into our meta-analysis. Random effects meta-analyses were calculated and presented as odds ratio (OR) with corresponding 95% confidence intervals (CI).

Results:

Thirteen studies containing 5260 patients were subjected to our analysis. Cut-off level of platelet was 150/nL in 5 studies with 1627 patients and 100/nL in 7 studies with 1536 patients. One study evaluated both cut-off levels in 2097 patients. Compared with PLT > 150/nL, patients with PLT < 150/nL had higher PHLF (OR 4.79, 95% CI 2.89 – 7.94) and mortality rate (OR 3.92, 95% CI 1.52 – 10.06). Similarly, patients with PLT < 100/nL had a significant increased risk of PHLF (OR 3.21, 95% CI 1.92 – 5.35) and mortality (OR 7.15, 95% CI 3.31 – 15.44) compared to patients with PLT > 100/nL.

Conclusion:

For the first time in a meta-analysis, we showed that perioperative low PLT correlates significantly with higher PHLF and mortality after liver resection. Approximately all of the studies provided retrospective analysis or included minor hepatectomy with low risk of PHLF and mortality. Therefore, further prospective studies focusing on extended hepatectomy with high risk of PHLF and mortality are needed to highlight the predictive role of perioperative PLT.