Background: We designed this study to analyze the feasibility of laparoscopic living donor hepatectomy by comparing to open living donor hepatectomy.

Methods : Living donors who underwent living donor right hepatectomy or extended right hemihepatectomy, both laparoscopy and open surgery, from May 2013 to October 2017 were included to the study. Comparison between laparoscopic surgery and open surgery was performed using Student's t-test, Mann-Whitney test, chi-square test, Fisher's exact test and linear-by-linear association.

Results : During the period 305 patients underwent living donor right hemihepatectomy or extended right hemihepatectomy. While 100 patients underwent laparoscopic surgery, 205 patients underwent open surgery. Laparoscopy group (30.9±11.2 years) had significantly younger age compared to open group (34.5±12.3 years, P=0.014). Laparoscopy group mostly had type 1 (95.0%) bile duct and 81% had single bile duct in liver grafts compared to open group. (59.5% type 1 bile duct and 59.5% of single bile duct) The laparoscopy group had significantly longer operation time (378.2 ± 93.5 minutes vs. 329.1 ± 68.0 minutes, P<0.001) and warm ischemic time (median 271 minutes vs. median 151 minutes, P<0.001) compared to open group. However, estimated blood loss was small in laparoscopy group. (298.3 ± 162.9 mL vs. 344.3 ± 149.9 mL, P=0.015) There was no difference in complication rate. (laparoscopy group 22.0% vs. open group 15.6%, P=0.170) The severity of complications classified by Clavien-Dindo system did not differ significantly between the groups. (P=0.094)

Conclusions: When living donors are selected cautiously, laparoscopic living donor hepatectomy can performed safely with similar outcome to open surgery. However, the procedure should be performed by experienced surgeon both in liver transplantation and minimal invasive surgery.

CITATION INFORMATION: Rhu J., Choi G., Kim J., Joh J., Kwon C., Kim S. The Feasibility of Laparoscopic Living Donor Right Hepatectomy Compared to Open Surgery Including 100 Laparoscopic Cases Am J Transplant. 2017;17 (suppl 3).

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