Ann Surg Treat Res.  2022 Jul;103(1):40-46. 10.4174/astr.2022.103.1.40.

Pure laparoscopic versus open right donor hepatectomy including the middle hepatic vein: a comparison of outcomes and safety

• Park JH
• Suh S
• Hong SK
• Lee S
• Hong Sy
• Choi Y
• Yi NJ
• Lee KW
• Suh KS

• KMID: 2531146
• DOI: http://doi.org/10.4174/astr.2022.103.1.40

Abstract

Purpose
Analyses on pure laparoscopy in donor hepatectomies, including the middle hepatic vein (MHV), are still scarce. This study aimed to compare the outcomes of donor right hepatectomy, including the MHV, when performed laparoscopically with conventional open surgery.
Methods
Data from living donors who underwent donor right hepatectomy between January 2012 and December 2020 were retrospectively analyzed. The intraoperative and postoperative complication rates of the pure laparoscopic donor right hepatectomy (PLDRH) with MHV inclusion (PLDRHM) group were compared with the conventional open donor right hepatectomy with MHV inclusion (CDRHM) group and the PLDRH without MHV inclusion [PLDRHM(–)] group.
Results
Compared to the CDRHM group, the PLDRHM group had a longer bench time (P < 0.001) and higher Δ%,calculated as [(preoperative value – postoperative value)/preoperative value] × 100, of AST (P < 0.001), ALT (P < 0.001), and total bilirubin (P = 0.023), but shorter hospital stay (P = 0.004) and a lower rate of complications (P = 0.005). Compared to the PLDRHM(–) group, the PLDRHM group had fewer male donors (P < 0.001) and a lower body mass index (P < 0.001), estimated total liver volume (P < 0.001), and real graft weight (P < 0.001). Results of laboratory changes, hospital stays, and complication rates were similar between the 2 groups.
Conclusion
PLDRH with the inclusion of the MHV in selected donors and recipients is feasible and safe when performed by surgeons experienced in laparoscopic surgery, with favorable complication rates compared to CDRHM and PLDRHM(–).

Keyword

Hepatectomy; Laparoscopy; Liver transplantation

Figure

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  Fig. 1 Study design. MHV, middle hepatic vein; CDRHM, conventional open donor right hepatectomy with MHV inclusion; PLDRHM, pure laparoscopic donor right hepatectomy with MHV inclusion; PLDRHM(–), pure laparoscopic donor right hepatectomy without MHV.

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