Objective  To systematically review the effects of perioperative glucocorticoids in alleviating postoperative stress and complications in patients undergoing hepatic resection.

Methods  PubMed, Cochrane Library, Web of Science, Embase, SinoMed, WanFang Data, CNKI and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on perioperative glucocorticoids in hepatectomized patients from inception to 30 April 2025. Two researchers independently screened the literature, extracted data, and assessed the risk of bias in the included studies. Meta-analysis was then conducted using RevMan 5.4 software.

Results  A total of 15 RCTs involving 1,332 patients were included. Meta-analysis results indicated that the rate of total complications [RR=0.73, 95%CI (0.62, 0.87), P<0.001], postoperative infections [RR=0.59, 95%CI (0.38, 0.91), P=0.02], and liver failure [RR=0.66, 95%CI (0.45, 0.98), P=0.04] in the glucocorticoids group were lower than control group, inflammatory factors such as C-reactive protein (CRP) [SMD=-0.83, 95%CI (-1.02, -0.65), P<0.001], and interleukin-6 (IL-6) [SMD=-0.99, 95%CI (-1.17, -0.80), P<0.001] in the glucocorticoids group were lower than control group; and liver function indexes such as total bilirubin (TBIL) [SMD= -0.59, 95% CI (-0.88, -0.29), P<0.001], and aspartate aminotransferase (AST) [SMD=- 0.96, 95%CI (-1.59 -0.33), P=0.03],  and alanine aminotransferase (ALT) [SMD=-1.20, 95%CI (-2.16, -0.24), P=0.01] levels in the glucocorticoids group were lower than control group; the length of hospital stay in the glucocorticoids group was shorter than control group [MD=-1.24, 95%CI (-2.43, -0.05), P=0.04].

Conclusion  Perioperative use of glucocorticoids significantly reduces the incidence of overall postoperative complications, infections, and liver failure in hepatectomy patients, decreases the release of inflammatory factors, promotes postoperative liver function recovery, and shortens hospital stay, promote patients' post-operative recovery.

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