Ann Liver Transplant.  2023 Nov;3(2):94-99. 10.52604/alt.23.0015.

Analyzing bench-surgery time: A comparative study of pure laparoscopic and open left hepatectomy including the middle hepatic vein in living liver donors

• Hong SK
• Kim M
• Kim Y
• Kim JY
• Lee J
• Kim J
• Hong Sy
• Lee JM
• Choi Y
• Yi NJ
• Lee KW
• Suh KS

• KMID: 2560929
• DOI: http://doi.org/10.52604/alt.23.0015

Abstract

Background
Pure laparoscopic donor hepatectomy (PLDH) has garnered attention due to its potential advantages in donor cosmesis and functional outcomes. This study focuses on bench-surgery in pure laparoscopic donor left hepatectomy (PLDLH) and compares it with conventional donor left hepatectomy (CDLH).
Methods
We conducted a retrospective analysis of donor records, specifically comparing PLDLH, including the middle hepatic vein (MHV), performed from November 2015 to January 2018 with CDLH, including MHV, performed from August 2014 to September 2015. Key parameters examined encompassed bench-surgery time and the number of openings in the hepatic vein, portal vein, hepatic artery, and bile duct within the procured graft.
Results
PLDLH exhibited significantly longer bench-surgery time (45.0 vs. 24.0 min, p=0.028), liver removal time (244.5 vs. 177.0 min, p=0.038), and warm ischemic time (10.5 vs. 3.0 min, p<0.001) when compared to CDLH. However, graft weight and the number of openings in the hepatic vein, portal vein, hepatic artery, and bile duct were similar between the two groups.
Conclusion
This study objectively demonstrates that PLDLH requires a longer duration of bench-surgery than CDLH, suggesting the necessity for additional steps during bench-surgery. It emphasizes the crucial role of a skilled surgical team in both bench-surgery and recipient surgery for the successful execution of PLDLH and achieving recipient outcomes comparable to those of CDLH.

Keyword

Liver transplantation; Living donors; Hepatectomy; Laparoscopy; Transplants