Background

With the development of laparoscopic skills, its application has expanded in living donor liver transplantation. However, due to technical difficulties, pure laparoscopic donor hepatectomy (PLDH) is performed few centers. In this report, we compare the safety and early outcomes of PLDH and open donor hepatectomy (ODH). Moreover, the learning curve of each group was analyzed and compared during the experienced period.

Methods

Total of 78 consecutive living liver donors underwent the right hepatectomy from January 2010 to March 2017. Of these, 43 living donors underwent the ODH and the 35 donors underwent the PLDH. Two donors of the PLDH group underwent open conversion due to bleeding and large graft size. The learning curve was defined using the moving average method.

Results

Except for the size of the right portal vein (PLDH 13.4± 6.3 mm, ODH 10.8± 3.2; p=0.03) donor demographic including age, sex, body mass index (BMI), fatty change and vascular and biliary anomaly were comparable. There were no significant differences in the operation time, estimated blood loss (EBL), intra-operative transfusion, hospital stay and postoperative complications during the whole period. However, when compared in the experience period after the learning curve (PLDH > 15 cases, ODH > 17 cases), the EBL was lower (PLDH 397.2 ± 302.6 ml, ODH 511.5 ± 584.0 ml; p=0.04) and graft weight was larger (PLDH 787.2 ± 238.6 g, ODH 671.3 ± 190.4 g; p=0.039) in the PLDH versus ODH.

Conclusion

In conclusion, the PLDH can be performed safely without increasing the risk compared with ODH. Moreover, after the learning curve, PLDH was more favorable in terms of blood loss.

CITATION INFORMATION: Lee B., Choi Y., Han H., Yoon Y., Cho J. Comparison of Pure Laparoscopic vs Open Living Donor Right Hepatectomy Am J Transplant. 2017;17 (suppl 3).

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