Comment on: Portal vein embolization versus dual vein embolization for management of the future liver remnant in patients undergoing major hepatectomy: meta-analysis

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The systematic review and meta-analysis by Bell et al.^1^ is of great interest and they are congratulated for their valuable study. However, the following comments on the results of the study are offered.

Bell et al.^1^ concluded that dual vein embolization was associated with a lower mortality rate compared with portal vein embolization, as depicted in the forest plot in Figure 4 of their article. However, a significant error in this forest plot erroneously altered the direction of the pooled effect size, creating a false impression of a beneficial effect on mortality rates. Specifically, the reported number of events in the two groups from the study by Le Roy et al.^2^ was inaccurate. The number of mortalities in the dual vein embolization group should be three, not one. Upon re-analysing the data using the fixed-effect model, there is no significant difference between the two groups (OR 0.43, 95% c.i. 0.16 to 1.12; P = 0.080) (Fig. 1), with no heterogeneity among the studies.

In conclusion, contrary to the findings of Bell et al.^1^, the corrected analysis of the available evidence does not support the superiority of dual vein embolization over portal vein embolization in reducing mortality in major hepatectomy. It is crucial to present this corrected finding to the readers of BJS Open to avoid misinterpretation of these results.