title: Use of pre-operative steroids in liver resection: a systematic review and meta-analysis.
abstract: BACKGROUND
  By attenuating the systemic inflammatory response to major surgery, the pre-operative administration of steroids may reduce the incidence of complications.
  
  
  METHODS
  A systematic review was conducted to identify randomized controlled trials (RCT) comparing pre-operative steroid administration with placebo during a liver resection. Meta-analyses were performed.
  
  
  RESULTS
  Five RCTs were identified including a total of 379 patients. Pre-operative steroids were associated with statistically significant reductions in the levels of serum bilirubin and interleukin 6 (IL-6) on post-operative day one. There was a trend towards a lower incidence of post-operative complications and prothrombin time (PT), but this did not reach statistical significance.
  
  
  CONCLUSIONS
  Pre-operative steroids may be associated with a clinically significant benefit in liver resection.
authors: Department of Surgery, Westmead Hospital, Sydney, NSW, Australia; Discipline of Surgery, University of Sydney, Sydney, NSW, Australia.
authors: Arthur J
authors: AJ
authors: Richardson
authors: Jerome M
authors: JM
authors: Laurence
authors: Vincent W T
authors: VW
authors: Lam
mesh_terms: D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016017:Odds Ratio; D011300:Preoperative Care; D011517:Prothrombin Time; D012307:Risk Factors; D013256:Steroids / Q000008:administration & dosage*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D013256:Steroids; D001663:Bilirubin