Background

In the early period, laparoscopic liver resection was applied in limited cases, but now the number of cases and its application is rapidly increasing. The purpose of this study was to investigate whether the laparoscopic living donor right hepatectomy could be performed safely.

Materials and Methods

Ten patients who were diagnosed with hepatocellular carcinoma (HCC) between 2003 and 2008 (Early period) underwent the laparoscopic right hepatectomy (LRH). A total 68 patients underwent LRH from 2009 to 2017 (Later period) (Living donor LRH n=35, HCC (≤ pT2) LRH n=33). We compared the perioperative outcomes of LRH between early period and late period in HCC patients. Moreover, we compared the outcomes of LRH in HCC patients and Living donors in the late period.

Results

There was no significant differences in the age, sex, body mass index (BMI) and presence of cirrhosis of the patients when comparing LRH of early and late period in HCC patients. However, the perioperative outcomes were significantly improved in the late period. (Early period : Late period, Operation time (mins) 468.7±177.8 vs 342.5±130.6, p=0.020 ; Intra-operative transfusion rate (%) 60% vs 21.2%, p=0.044 ; Hospital stay (days) 16.4 ± 8.61 vs 9.90 ± 5.20, p=0.020). When comparing the outcomes of LRH in HCC patients and Living donors in the late period, the demographics of the patients were significantly different in both groups. HCC patients were significantly older and had more comorbidities than living donors. However, there was no significant difference in perioperative outcomes between two groups. (Living donors : HCC patients, Operation time (mins) 433.7±142.9 vs 365.9±140.9, p=0.260 ; Intra-operative transfusion rate (%) 6.1% vs 9.5%, p=0.638 ; Hospital stay(days) 9.70±4.35 vs 9.19±5.08, p=0.165). There was no significantly difference in postoperative complications in between two groups.

Conclusion

When experience with LRH reaches to a stable level, Living donor LRH can be performed safely.

CITATION INFORMATION: Choi Y., Han H., Yoon Y., Cho J., Lee B. Advancement in Perioperative Outcomes of Living Donors in Pure Laparoscopic Right Hepatectomy Am J Transplant. 2017;17 (suppl 3).

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