Effect of infrahepatic inferior vena cava clamping on bleeding during hepatic resection: A meta-analysis

Abstract

This meta-analysis aimed to explore the effect of infrahepatic vena cava (IVC) clamping on bleeding during hepatic resection. PubMed and Embase databases were searched systematically to identify randomized controlled trials (RCTs) comparing infrahepatic IVC clamping to IVC nonclamping during hepatic resection. A random-effects model was used to calculate weight and outcome measures. Five RCTs involving a total of 596 patients were identified for inclusion: 299 in infrahepatic IVC clamping group and 297 in nonclamping group. Infrahepatic IVC clamping was associated with a statistically significant reduction in total intraoperative blood loss (weighted mean difference [WMD] -181.72, 95% confidence interval [95% CI] -329.03 to -34.4; P = 0.02) and blood loss during parenchymal transaction (WMD -160.58, 95% CI, -261.9 to -59.27; P = 0.002). Postoperative morbidity, mortality, and hospital stay were comparable in both groups. Data from currently available literature suggest that infrahepatic IVC clamping is a safe procedure that facilitates intraoperative bleeding control during hepatic resection.

Keywords: Bleeding; Hepatic resection; Infrahepatic vena cava clamping; Meta-analysis.