Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2023; 15(2): 249-257
Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.249
Hypophosphatemia as a prognostic tool for post-hepatectomy liver failure: A systematic review
Romualdas Riauka, Povilas Ignatavicius, Giedrius Barauskas
Romualdas Riauka, Povilas Ignatavicius, Giedrius Barauskas, Department of Surgery, Lithuanian University of Health Sciences, Kaunas 50161, Lithuania
Author contributions: Riauka R, Ignatavicius P and Barauskas G contributed to study design and conception, data collection, analysis and interpretation and writing the draft of the manuscript; and all authors read and approved the published version of the manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Povilas Ignatavicius, MD, PhD, Academic Research, Doctor, Lecturer, Surgeon, Department of Surgery, Lithuanian University of Health Sciences, Eiveniu 2, Kaunas 50161, Lithuania. povilas.ignatavicius@lsmuni.lt
Received: July 19, 2022
Peer-review started: July 19, 2022
First decision: August 19, 2022
Revised: September 1, 2022
Accepted: November 28, 2022
Article in press: November 28, 2022
Published online: February 27, 2023
ARTICLE HIGHLIGHTS
Research background

Post-hepatectomy liver failure (PHLF) is a severe and serious complication occurring after high-volume liver resections and presenting with high perioperative mortality rates. There are contradictory results regarding serum phosphorus association with postoperative outcomes. Changes in serum phosphorus levels might predict development of PHLF and improve its treatment results.

Research motivation

Data of serum phosphorus level changes as a prognostic tool for PHLF is scarce and needs to be systemically analyzed.

Research objectives

To perform the first systematic review analyzing hypophosphatemia as a prognostic tool for PHLF and general complications.

Research methods

Study protocol for the review was registered in the International Prospective Register of Systematic Reviews database (D42020197717). This systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses guidelines. PubMed, Cochrane and Lippincott Williams & Wilkins databases were searched up to March 31, 2022 using relevant search terms.

Research results

After thorough research, nine studies with 1677 patients were included in the systematic review. The majority of the included studies were retrospective. However, due to high heterogeneity between included studies there were not enough data to perform appropriate the meta-analysis.

Research conclusions

Changes of postoperative serum phosphorus concentration may be useful for predicting outcomes of patients after extensive liver resections. However, the decision to measure and interpret results needs to be considered individually with routine phosphorus level measurements, and its benefits remain questionable.

Research perspectives

Further high volume, non-randomized studies are needed to better analyze postoperative hypophosphatemia as a predictive factor for PHLF and general surgical outcomes.