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Cited by 2Enhanced Recovery After SurgeryCancer, Stress, Anesthesia, and Immune ResponseHyperglycemia and glycemic control in critically ill and hospitalized patients

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

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Yan, Xiangyu, Huang, Songhan, Li, Feiyu, Jiang, Liyong, Jiang, Yong, Liu, Jun·2023·BMJ Open
DOI 10.1136/bmjopen-2022-068969PMC PMC10186463
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Abstract

Objective: The purpose of this systematic review and meta-analysis was to investigate whether glucocorticoid might be beneficial after hepatectomy. Design: Systematic review and meta-analysis. Data sources: PubMed, Embase, Cochrane Library and Web of Science. Eligibility criteria: We included studies assessing the efficacy of perioperative glucocorticoid administration in patients undergoing liver surgery. Data extraction and synthesis: Four 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. Results: Fourteen 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. Conclusion: Current 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 number: CRD42022307533.

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  • Pooled analysis of IL-6 levels showed significantly decreased levels in the glucocorticoid administration cohorts, with a mean difference of −53 pg/mL on POD1 and −22 pg/mL on POD3 (both p < 0.001).

    “Pooled analysis of IL-6 levels showed significantly decreased levels in the glucocorticoid administration cohorts, with a mean difference of −53 pg/mL on POD1 and −22 pg/mL on POD3 (both p < 0.001).”

    From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [42]

    The Results section, under “Secondary outcomes: laboratory evaluations” (page not available), reports pooled IL-6 mean differences of −53.05 on POD 1 and −21.89 on POD 3, both with p<0.0001. These support the rounded estimates and significance in the claim, but our copy does not specify that the differences are measured in pg/mL. (LLM, conf=0.85)

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  • A recent meta-analysis of RCTs assessing perioperative glucocorticoids in patients undergoing liver surgery revealed a lower risk of overall complications (RR 0.77, 95% CI 0.64-0.92).

    “A recent meta-analysis of RCTs assessing perioperative glucocorticoids in patients undergoing liver surgery revealed a lower risk of overall complications (RR 0.77, 95% CI 0.64–0.92)”

    From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [42]

  • The same meta-analysis revealed improvement in early postoperative (POD1-3) laboratory markers associated with inflammation (IL-6/CRP) and liver function (international normalized ratio/total bilirubin/albumin).

    “as well as improvement in early postoperative (POD1-3) laboratory markers associated with inflammation (IL-6/CRP) and liver function (international normalized ratio/total bilirubin/albumin) [42].”

    From The Role of Perioperative Interleukin-6 Serum Levels on Liver Dysfunction and Infectious Complications After Hepatectomy—A Systematic Review (2025) · cites this paper as [42]

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Cited by

Sorted by citations

Authors
Yan, X., Huang, S., Li, F., Jiang, L., Jiang, Y., & Liu, J.
Affiliations
Shandong University (CN)
Corresponding author
Liu, Jun
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2023-05
Volume
13
Issue
5
Pages
e068969
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2022-068969
PMC
PMC10186463
OpenAlex
W4376223837
Cited by
2
References
1
Citations by year
2026: 1 · 2025: 1
FWCI
0.13
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Open (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Natural Science Foundation of China (81373172, 81770646)
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hyperglycemia and glycemic control in critically ill and hospitalized patients
Keywords
perioperative glucocorticoids, hepatectomy, liver surgery, postoperative complications, length of hospital stay, postoperative inflammation, interleukin-6, C-reactive protein, postoperative liver function, bilirubin, albumin, international normalized ratio
MeSH terms
Glucocorticoids, Humans, Liver, Postoperative Complications, Randomized Controlled Trials as Topic

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