Ann Hepatobiliary Pancreat Surg.  2020 Feb;24(1):33-37. 10.14701/ahbps.2020.24.1.33.

Comparison of liver regeneration in laparoscopic versus open right hemihepatectomy for adult living donor liver transplantation

Affiliations
  • 1Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. yjongman21@gmail.com

Abstract

BACKGROUNDS/AIMS
This study aims to compare differences between laparoscopic donor right hemihepatectomy (LDRH) and open donor right hemihepatectomy (ODRH) in the quality of the operation, postoperative complications, and liver regeneration measured via volumetry.
METHODS
This study included 119 patients who underwent living donor right hemihepatectomy at Samsung Medical Center from January 2016 to December 2017. We compared several aspects of LDRH and ODRH and analyzed the results using the independent t-test, chi-square test and Fisher's exact test.
RESULTS
Among 119 enrolled patients, 66 patients (55.5%) underwent open surgery, and 53 patients (44.5%) underwent laparoscopic surgery. The mean operation time was significantly shorter for ODRH (290.57±54.04 minutes) than LDRH (312.28±53.5 minutes) (p=0.031). Estimated blood loss was significantly less in LDRH (258.49±119.99 ml) than ODRH (326.52±157.68 ml) (p=0.011). The remnant liver recovered to 83.35±10.71% of the preoperative estimate whole liver volume (pre-EWLV) in the ODRH group and 84.04±8.98% of the pre-EWLV in the LDRH group (p=0.707). The percentage of increased estimated liver volume to postoperative estimate remnant liver volume (post-ERLV) was 137.62±40.34% in the ODRH group and 130.56±36.78% in the LDRH group, and there was no statistically significant difference between the two groups (p=0.326). An analysis of postoperative complications showed no significant differences.
CONCLUSIONS
LDRH is safe, and there is no significant difference in hepatic regeneration compared with ODRH. Therefore, LDRH can be applied for living donation of liver.

Keyword

Living donor right hemihepatectomy; Laparoscopic donor right hemihepatectomy; Liver transplantation; Liver regeneration; Volumetry

MeSH Terms

Adult*
Humans
Laparoscopy
Liver Regeneration*
Liver Transplantation*
Liver*
Living Donors*
Postoperative Complications
Regeneration
Tissue Donors
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