TY - JOUR
T1 - Clinical outcomes of patients with and without diabetes mellitus after hepatectomy
T2 - A systematic review and meta-analysis
AU - Li, Qingshan
AU - Wang, Yue
AU - Ma, Tao
AU - Lv, Yi
AU - Wu, Rongqian
N1 - Publisher Copyright:
© 2017 Li et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/2
Y1 - 2017/2
N2 - Background Clinical data regarding the influence of diabetes mellitus (DM) on the outcomes of patients undergoing hepatectomy are conflicting. To determine the impact of DM on the clinical outcomes of patients undergoing hepatectomy, we systematically reviewed published studies and carried out a meta-analysis. Methods A systematic literature search of Pubmed, Sciencedirect, Web of Science, and Chinese Biomedical Database was conducted from their inception through February 2, 2016. The combined relative risk (RR) or hazard ratio (HR) with 95% confidence intervals (95% CI) was calculated. Results A total of 16 observational studies with 15710 subjects were eligible for meta-analysis. The pooled results showed that DM significantly increased the risk of overall postoperative complications (RR 1.34; 95% CI 1.19-1.51; P<0.001), DM-associated complications (RR 1.8; 95% CI 1.29-2.53; P<0.001), liver failure (RR 2.21; 95% CI 1.3-3.76; P = 0.028) and postoperative infections (RR 1.59; 95% CI 1.01-2.5; P = 0.045). In addition, DM was also found to be significantly associated with unfavorable overall survival and disease free survival after liver resection. The pooled HR was 1.63 (95% CI 1.33-1.99; P<0.001) for overall survival and 1.55 (95% CI 1.07-2.25; P = 0.019) for disease free survival. Conclusion DM is associated with poor outcomes in patients undergoing hepatectomy. DM should be taken into account cautiously in the management of patients undergoing hepatectomy. Further prospective studies are warranted to explore effective interventions to improve the poor outcomes of diabetic patients undergoing hepatectomy.
AB - Background Clinical data regarding the influence of diabetes mellitus (DM) on the outcomes of patients undergoing hepatectomy are conflicting. To determine the impact of DM on the clinical outcomes of patients undergoing hepatectomy, we systematically reviewed published studies and carried out a meta-analysis. Methods A systematic literature search of Pubmed, Sciencedirect, Web of Science, and Chinese Biomedical Database was conducted from their inception through February 2, 2016. The combined relative risk (RR) or hazard ratio (HR) with 95% confidence intervals (95% CI) was calculated. Results A total of 16 observational studies with 15710 subjects were eligible for meta-analysis. The pooled results showed that DM significantly increased the risk of overall postoperative complications (RR 1.34; 95% CI 1.19-1.51; P<0.001), DM-associated complications (RR 1.8; 95% CI 1.29-2.53; P<0.001), liver failure (RR 2.21; 95% CI 1.3-3.76; P = 0.028) and postoperative infections (RR 1.59; 95% CI 1.01-2.5; P = 0.045). In addition, DM was also found to be significantly associated with unfavorable overall survival and disease free survival after liver resection. The pooled HR was 1.63 (95% CI 1.33-1.99; P<0.001) for overall survival and 1.55 (95% CI 1.07-2.25; P = 0.019) for disease free survival. Conclusion DM is associated with poor outcomes in patients undergoing hepatectomy. DM should be taken into account cautiously in the management of patients undergoing hepatectomy. Further prospective studies are warranted to explore effective interventions to improve the poor outcomes of diabetic patients undergoing hepatectomy.
UR - https://www.scopus.com/pages/publications/85012108921
U2 - 10.1371/journal.pone.0171129
DO - 10.1371/journal.pone.0171129
M3 - 文章
C2 - 28182632
AN - SCOPUS:85012108921
SN - 1932-6203
VL - 12
JO - PLoS ONE
JF - PLoS ONE
IS - 2
M1 - e0171129
ER -
