Short-term outcomes of perioperative glucocorticoid administration in patients undergoing liver surgery: a systematic review and meta-analysis of randomised controlled trials

Abstract

ObjectiveThe purpose of this systematic review and meta-analysis was to investigate whether glucocorticoid might be beneficial after hepatectomy.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library and Web of Science.Eligibility criteriaWe included studies assessing the efficacy of perioperative glucocorticoid administration in patients undergoing liver surgery.Data extraction and synthesisFour data bases were retrieved for all randomised controlled trials. We considered postoperative complications, hospital stay and postoperative chemistry evaluations as outcomes. Pooled effects of dichotomic variables were expressed as relative risk (RR) with a 95% CI. The mean difference was used for continuous variables and an inverse variance statistical method was adopted.ResultsFourteen studies with 1205 patients were included. Lower risk of overall complications was associated with glucocorticoid (RR, 0.77; 95% CI 0.64 to 0.92), while no difference was found in hospital stay (RR, 0.02; 95% CI −0.47 to 0.51). There were also improvements in postoperative chemistry evaluations including interleukin 6 on day 1 and 3, C reactive protein on day 1, 2 and 3, international normalised ratio on day 2, total bilirubin on day 1, 2, 3 and 5, albumin on day 1.ConclusionCurrent evidence indicated that perioperative glucocorticoid administration for patients undergoing hepatectomy reduced the risk of overall complications with inhibited postoperative inflammatory response and improved postoperative liver function.PROSPERO registration numberCRD42022307533.