Pure Laparoscopic Donor Hepatectomy: A Multicenter Experience

医学 肝切除术 外科 肝移植 单中心 普通外科 移植 切除术
作者
Suk Kyun Hong,Gyu‐Seong Choi,Jaryung Han,Hwui‐Dong Cho,Jong Man Kim,Young Seok Han,Jai Young Cho,Choon Hyuck David Kwon,Ki‐Hun Kim,Kwang‐Woong Lee,Ho‐Seong Han,Kyung‐Suk Suh
出处
期刊:Liver Transplantation [Wiley]
卷期号:27 (1): 67-76 被引量:44
标识
DOI:10.1002/lt.25848
摘要

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.

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