HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Postoperative complications following hepatectomy for hepatocellular carcinoma in patients with Child-Pugh B liver function: a systematic review and meta-analysis.
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Yang Jiahui, Li Wenjie, Deng Kai, Kong Qingyan, Peng Wei, Chen Zheyu
Аннотация
BACKGROUND: Liver resection is a curative option for hepatocellular carcinoma (HCC), but its safety in patients with Child-Pugh B cirrhosis remains incompletely defined, and quantitative complication benchmarks are lacking.
METHODS: This systematic review and single-proportion meta-analysis followed PRISMA Harms guidelines. PubMed, Web of Science, Embase, and Cochrane Library were searched for studies reporting outcomes after curative-intent hepatectomy in Child-Pugh B HCC patients. Pooled proportions were calculated using generalized linear mixed models with logit transformation and random-effects models.
RESULTS: 14 studies comprising 1238 patients were included. The pooled overall complication rate (Clavien-Dindo grade I-V) was 38.22% (95% CI, 30.05%-47.12%), and the trim-and-fill adjusted major complication rate (Clavien-Dindo ≥ III) was 14.87% (95% CI, 10.48%-20.67%). The 30-day and 90-day mortality rates were 1.09% (95% CI, 0.20%-5.59%) and 2.56% (95% CI, 1.43%-4.53%), respectively. Surgical approach was a significant moderator of major complications (open 18.18% vs. minimally invasive 7.83%; P = 0.01).
CONCLUSION: These findings provide preliminary quantitative safety estimates that offer a useful reference for clinicians and patients and may help frame shared decision-making at the patient level.
METHODS: This systematic review and single-proportion meta-analysis followed PRISMA Harms guidelines. PubMed, Web of Science, Embase, and Cochrane Library were searched for studies reporting outcomes after curative-intent hepatectomy in Child-Pugh B HCC patients. Pooled proportions were calculated using generalized linear mixed models with logit transformation and random-effects models.
RESULTS: 14 studies comprising 1238 patients were included. The pooled overall complication rate (Clavien-Dindo grade I-V) was 38.22% (95% CI, 30.05%-47.12%), and the trim-and-fill adjusted major complication rate (Clavien-Dindo ≥ III) was 14.87% (95% CI, 10.48%-20.67%). The 30-day and 90-day mortality rates were 1.09% (95% CI, 0.20%-5.59%) and 2.56% (95% CI, 1.43%-4.53%), respectively. Surgical approach was a significant moderator of major complications (open 18.18% vs. minimally invasive 7.83%; P = 0.01).
CONCLUSION: These findings provide preliminary quantitative safety estimates that offer a useful reference for clinicians and patients and may help frame shared decision-making at the patient level.