ThP4.2 - Role of LiMAx in the Risk Assessment of Postoperative Outcomes in Patients undergoing Liver Resection: A Systematic Review and Meta-Regression Analysis Free

LiMAx is a novel test for assessing the metabolic capacity and dynamic function of the liver. The current review aims to investigate the predictive role of LiMAx for postoperative outcomes in patients undergoing liver resection.

A systematic review was conducted using EMBASE, Web of Science, Medline and Cochrane Library databases. Preoperative LiMAx values and various postoperative outcomes were extracted (e.g. mortality, post-hepatectomy liver failure). Pooled averages were calculated where appropriate. Postoperative complications in relation to the extent of resection and LiMAx values were the outcomes assessed.

13 studies, comprising 1668 participants and 20 separate cohorts in total, were included. The meta-regression of preoperative LiMAx and postoperative outcomes yielded non-significant results (p>0.05). A second meta-regression highlighted significant correlations between extra major surgery rate and various outcomes (p<0.05), suggesting its confounding role in the first regression. A further analysis found a non-significant tendency for mortality to correlate with LiMAx as expected in patients undergoing minor resection.

In this review, there was no statistical correlation between LiMAx values and post-hepatectomy outcomes. The LiMAx test was relatively more helpful in predicting mortality in patients undergoing minor resection; this was likely confounded by selection bias in the low quality studies. Larger multi-centre studies with standardised reporting of outcomes are required.