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A Safe and Feasible Method for Initiating Pure Laparoscopic Living Donor Right Hepatectomy; External Traction of the Cystic Duct

H. Choi1, G. Na2, H. Park1, Y. Woo1, Y. Choi1, Y. You3

1Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea, Republic of, 2Bucheon St. Mary's Hospital, The Catholic University of Korea, Bucheon, Korea, Republic of, 3Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea, Republic of

Meeting: 2022 American Transplant Congress

Abstract number: 1766

Keywords: Laparoscopy, Living donor

Topic: Clinical Science » Liver » 58 - Liver: Living Donor Liver Transplant and Partial Grafts

Session Information

Session Name: Liver: Living Donor Liver Transplant and Partial Grafts

Session Type: Poster Abstract

Date: Tuesday, June 7, 2022

Session Time: 7:00pm-8:00pm

 Presentation Time: 7:00pm-8:00pm

Location: Hynes Halls C & D

*Purpose: Laparoscopic major hepatectomy is gradually increasing with two consensus meetings. However, purely laparoscopic donor right hepatectomy (PLDRH) is still being performed carefully, because donor safety and quality grafts must be obtained. The external traction of the cystic duct can be helpful for hilar dissection and duct division.

*Methods: From March 2019 to December 2019, 86 patients underwent donor right hepatectomy except for 17 patients who used left graft. Forty of them underwent PLDRH and forty-six of them underwent open hepatectomy. PLDRH was performed using flexible scope and 5 ports. The gallbladder was not divided from the liver bed for traction after only cutting the cystic duct and artery. After tying the cystic duct stump in a ‘Round loop’, external traction was performed to the left side of the epigastric area. From the seventh patient with PLDRH, cystic duct traction method was used.

*Results: Their mean age was 40.4 ± 14.4 years and 8 (50.0%) were female. The average BMI was 22.8 (19.1~25.4) and the average graft volume was 778.8 (608~1300) mL The mean graft steatosis was 2.6%. The average operation time was 327.3 (250~380) minutes and the time from hepatic artery clamping to graft out was 18.9 (11~31) minutes. There was no intraoperative transfusion and no open conversion in all patients. One duct stricture developed as a surgical complication which was treated with ERBD insertion and there was one spontaneous pneumothorax during the operation. There was no re-operation or re-admission. Recipients also recovered well and there was a bile leak in one patient of the recipients.

*Conclusions: PLDRH still remains a challenging procedure requiring important experiences in both laparoscopic liver surgery and open living donor right hepatectomy. External traction of the cystic duct may be helpful for PLDRH.

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To cite this abstract in AMA style:

Choi H, Na G, Park H, Woo Y, Choi Y, You Y. A Safe and Feasible Method for Initiating Pure Laparoscopic Living Donor Right Hepatectomy; External Traction of the Cystic Duct [abstract]. Am J Transplant. 2022; 22 (suppl 3). https://atcmeetingabstracts.com/abstract/a-safe-and-feasible-method-for-initiating-pure-laparoscopic-living-donor-right-hepatectomy-external-traction-of-the-cystic-duct/. Accessed May 29, 2025.

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