Ann Hepatobiliary Pancreat Surg.  2019 Nov;23(4):313-318. 10.14701/ahbps.2019.23.4.313.

Pure 3D laparoscopy versus open right hemihepatectomy in a donor with type II and III portal vein variations

Affiliations
  • 1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea. lulu5050@naver.com
  • 2Liver Transplantation Unit, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Mansoura, Egypt.
  • 3Department of Surgery, Korea University College of Medicine, Seoul, Korea.

Abstract

BACKGROUNDS/AIMS
Pure laparoscopic living donor right hemihepatectomy (PLDRH) has been performed in many experienced centers. However, portal vein variations still remain challenging thus disturbing the widespread of PLDRH in many centers. PLDRH when integrated with 3-dimensional laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography is safe and feasible.
METHODS
We reviewed 19 donors with separated right anterior and right posterior portal veins who underwent living donor right hemihepatectomy between January 2014 and December 2016. We compared the clinical outcomes of PLDRH and conventional open right hemihepatectomy (CDRH).
RESULTS
6 donors (31.6%) underwent PLDRH while 13 donors (68.4%) underwent CDRH. There was no intraoperative complications, transfusions and open conversions in the PLDRH donors. The total operative time was longer in PLDRH (356.5 vs. 244.5 minutes, p=0.003). However, the length of hospital stay (8.5 vs. 9.0 days, p=0.703), blood loss (450.0 vs. 393.6 ml, p=0.557) and complication rate (16.6% vs.27.3%; p=0.327) did not differ between the two groups.
CONCLUSIONS
PLDRH is safe and feasible in donors with type II and III portal vein variations. Further prospective comparative studies are needed to prove the safety and efficacy of PLDRH.

Keyword

Portal vein variations; Pure laparoscopic donor hepatectomy; Open donor hepatectomy
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