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01-09-2020 | Laparoscopy | Original Scientific Report

Safe Strategy to Initiate Total Laparoscopic Donor Right Hepatectomy: A Stepwise Approach From a Laparoscopy-Assisted Method

Authors: Hao-Jan Lei, Niang-Cheng Lin, Cheng-Yen Chen, Shu-Cheng Chou, Meng-Hsuan Chung, Bor-Uei Shyr, Hsin-Lin Tsai, Cheng-Yuan Hsia, Chin-Su Liu, Che-Chuan Loong

Published in: World Journal of Surgery | Issue 9/2020

Abstract

Background

Total laparoscopic donor right hepatectomy (TLDRH) for adult living liver donors has been reported by a few experienced centers, but with limited cases, its safety and feasibility remain controversial. We report our experience initiating TLDRH using a stepwise approach to gradually convert laparoscopy-assisted donor right hepatectomy (LADRH) to TLDRH.

Methods

We retrospectively analyzed the data of 61 LADRHs, 56 conventional open donor right hepatectomies (CODRHs), and 3 TLDRHs performed between March 2014 and June 2018.

Results

There were no significant differences in perioperative outcomes between donors undergoing LADRH and CODRH, except for a slight elevations in the operative time (436.5 vs 392.9 min, p < 0.001) and the graft warm ischemic time (5.4 vs 4.0 min, p < 0.001) in the LADRH group. The recipients' posttransplant one-year survival rates in the LADRH and CODRH groups were also similar (93.2% and 94.6%, p = 0.384). For three donors in whom TLDRH was converted from LADRH in a stepwise manner, the average operative time and blood loss were 570 min and 316.7 ml, respectively. Donors were discharged on postoperative day 10 without any surgical complications.

Conclusions

LADRH can be performed routinely on liver living donors. A stepwise approach could be adopted to “covert” suitable donors from LADRH to a total laparoscopic procedure to maximize donor safety. This strategy is reliable and could be reproduced in most LDLT centers.

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Title: Safe Strategy to Initiate Total Laparoscopic Donor Right Hepatectomy: A Stepwise Approach From a Laparoscopy-Assisted Method
Authors: Hao-Jan Lei
Niang-Cheng Lin
Cheng-Yen Chen
Shu-Cheng Chou
Meng-Hsuan Chung
Bor-Uei Shyr
Hsin-Lin Tsai
Cheng-Yuan Hsia
Chin-Su Liu
Che-Chuan Loong
Publication date: 01-09-2020
Publisher: Springer International Publishing
Keyword: Laparoscopy
Published in: World Journal of Surgery / Issue 9/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05572-5

At a glance: The STEP trials

Springer Medicine

Safe Strategy to Initiate Total Laparoscopic Donor Right Hepatectomy: A Stepwise Approach From a Laparoscopy-Assisted Method

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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