*Purpose: Pure laparoscopic donor right hepatectomy (PLDRH) has been increasingly performed worldwide and reports of the outcomes of this procedure have been accumulated. However, further studies are still needed to draw solid conclusion on the safety and feasibility of PLDRH. This study aimed to report our 5 year experience of PLDRH with more than 400 cases, the largest until now.

*Methods: Prospectively collected medical records of donors who underwent pure laparoscopic right hepatectomy between November 2015 and December 2020 and their recipients were retrospectively reviewed. For the comparison, medical records of donors who underwent conventional right hepatectomy between January 2014 and October 2015 and their recipients were also reviewed.

*Results: Excluding laparoscopy assisted cases, 119 cases in conventional donor right hepatectomy (CDRH) group and 376 cases in PLDRH were enrolled. More donors in PLDRH had bile duct variation according to preoperative imagings compared to those in CDRH (30.3% vs. 41.5%; P=0.028). The operative time (237.5 vs. 260.9 min; P<0.001), warm ischemic time (4 vs. 13 min; P<0.001), and bench work time (43.1 vs. 59.2 min; P<0.001) were significantly longer in PLDRH than CDRH. Less estimated blood loss (300.8 vs. 257.8 mL; P=0.020) and shorter hospital stay (8.5 vs. 7.2 day; P<0.001) were checked in PLDRH than CDRH. There was no significant difference in postoperative complication between the two groups.

*Conclusions: Analyses using data of more than 400 cases of PLDRH and median follow up of more than 870 days showed clear safety and feasibility of PLDRH.

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