Z Gastroenterol 2018; 56(01): E2-E89
DOI: 10.1055/s-0037-1612829
Poster Visit Session IV Tumors, Liver Surgery and Transplantation – Saturday, January 27, 2018, 8:30am – 9:15am, Foyer area West Wing
Georg Thieme Verlag KG Stuttgart · New York

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

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

Publication History

Publication Date:
03 January 2018 (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. A systematic review and meta-analysis of published studies was conducted to evaluate the impact of perioperative platelet count on PHLF and mortality following hepatectomy.

Methods:

A systematic literature search was performed using PubMed and Web of Science. All studies comparing patients with perioperative low and high platelet count 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 in 7 studies comprising 1536 patients, the cut-off level of 100/nL was determined for platelet. One study evaluated both cut-off levels in 2097 patients. Compared with perioperative platelet count > 150/nL, patients with perioperative platelet count < 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 platelet count < 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 perioperative platelet count ≥100/nL.

Conclusion:

For the first time in a meta-analysis, we showed that perioperative low platelet count 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 platelet.