Pure Laparoscopic Donor Hepatectomy: A Multicenter Experience.
Suk Kyun HongGyu Seong ChoiJaryung HanHwui-Dong ChoJong Man KimYoung Seok HanJai Young ChoChoon Hyuck David KwonKi-Hun KimKwang-Woong LeeHo-Seong HanKyung-Suk SuhPublished in: Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society (2020)
According to recent international consensus conferences, pure laparoscopic donor hepatectomy (PLDH), particularly right and left hepatectomies, is not yet considered a standard practice because studies remain limited. Thus, we present the outcomes of more than 500 PLDH patients, mostly receiving a right hepatectomy. To our knowledge, this is the largest study to date on PLDH. Data from all living liver donors who underwent PLDH at 5 centers in Korea until June 2018 were retrospectively analyzed. The outcomes of both donors and recipients were included. Pearson correlation analysis was used to explore the relationship between the duration of surgery and cumulative experience at each center, which reflects the learning curve. Overall, 545 PLDH cases were analyzed, including 481 right hepatectomies, 25 left hepatectomies, and 39 left lateral sectionectomies (LLS). The open conversion was necessary for 10 (1.8%) donors, and none of the donors died or experienced irreversible disability. Notably, there were 25 (4.6%) patients with major complications (higher than Clavien-Dindo grade 3). All centers except one showed a significant decrease in surgery duration as the number of cases accumulated. Regarding recipient outcomes, there were 110 cases (20.2%) of early major complications and 177 cases (32.5%) of late major complications. This study shows the early and late postoperative outcomes of 545 donors and corresponding recipients, including 481 right hepatectomies and 25 left hepatectomies, from 5 experienced centers. Although the results are comparable to those of previously reported open donor hepatectomy series, further studies are needed to consider PLDH a new standard practice.
Keyphrases
- minimally invasive
- kidney transplantation
- healthcare
- primary care
- risk factors
- end stage renal disease
- robot assisted
- multiple sclerosis
- chronic kidney disease
- newly diagnosed
- clinical trial
- prognostic factors
- electronic health record
- patients undergoing
- type diabetes
- cross sectional
- surgical site infection
- adipose tissue
- quality improvement
- percutaneous coronary intervention
- case control
- peritoneal dialysis
- glycemic control