Evidence map›Paper›PMID 18622655›Full record

SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2009

Portal triad clamping versus vascular exclusion for vascular control during hepatic resection: a systematic review and meta-analysis.

Nuh N Rahbari, Moritz Koch, Arianeb Mehrabi, Kathrin Weidmann, Edith Motschall, Christoph Kahlert, Markus W Büchler, Jürgen Weitz

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Portal triad clamping versus other methods of vascular control in liver resection: a systematic review and meta-analysis.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2012
    Pooled it
  2. Pooled it
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  7. Review
  8. Article
  9. Article
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  11. Article
  12. Article
  13. Observational
  14. Article
  15. Combined liver and multivisceral resections.HPB surgery : a world journal of hepatic, pancreatic and biliary surgery · 2014
    Review
  16. Article
  17. Article
  18. Right hepatectomy with extra-hepatic vascular division prior to transection: intention-to-treat analysis of a standardized policy.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2012
    Article
  19. Review
  20. [Contribution of the Study Center of the German Surgical Society to evidence based surgery].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2011
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nuh N RahbariDepartment of Surgery, University of Heidelberg, Im Neuenheimer Feld 110, 69120 Heidelberg, Germany.
Moritz Koch
Arianeb Mehrabi
Kathrin Weidmann
Edith Motschall
Christoph Kahlert
Markus W Büchler
Jürgen Weitz

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo compare the clinical outcome of patients undergoing liver resection under portal triad clamping (PTC) versus hepatic vascular exclusion (HVE).

methodsA systematic literature search was performed following the guidelines of the Cochrane collaboration. Randomized controlled trials (RCT) comparing PTC to any technique of HVE were eligible for inclusion. Two authors independently assessed methodological quality of included trials and extracted data on overall morbidity, mortality, cardiopulmonary and hepatic morbidity, intraoperative blood loss, transfusion rates, postoperative transaminase and bilirubin levels, prothrombin time, and hospital stay. Meta-analyses were performed using a random-effects model.

resultsOf the 1,383 identified references, four RCTs were finally included. These trials compared PTC to selective hepatic vascular exclusion (SHVE), total hepatic vascular exclusion (THVE), and a modified technique of HVE (MTHVE), respectively. Meta-analyses revealed no significant difference in morbidity and mortality between PTC and techniques of HVE. Further analyses showed significantly reduced overall morbidity for the PTC compared to the THVE group. There was a significantly lower transfusion rate for HVE compared to PTC.

conclusionHepatic vascular exclusion does not offer any benefit regarding outcome of patients undergoing hepatic resection compared to PTC alone. Further, well-designed RCTs evaluating adequate vascular control in major hepatectomy and in patients with underlying liver disease appear justified.

Indexed as

ConstrictionHemostasis, SurgicalHepatectomyHumansPortal SystemRandomized Controlled Trials as Topic

Identifiers

PMID18622655

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.