The First Comparative Study of the Perioperative Outcomes between Pure Laparoscopic Donor Hepatectomy and Laparoscopy-Assisted Donor Hepatectomy in a Single Institution

Takeshi Takahara, Go Wakabayashi, Hiroyuki Nitta, Yasushi Hasegawa, Hirokatsu Katagiri, Akira Umemura, Daiki Takeda, Kenji Makabe, Koki Otsuka, Keisuke Koeda, Akira Sasaki

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Abstract

Background In a statement from the second International Consensus Conference for Laparoscopic Liver Resection, adult-to-adult laparoscopic donor surgery was the earliest phase of development. It was recommended that the procedure be performed under institutional ethical approval and a reporting registry. Method At our institute, we started laparoscopy-assisted donor hepatectomy (LADH) in 2007 and changed to pure laparoscopic donor hepatectomy (PLDH) in 2012. This study included 40 living donors who underwent LADH and 14 live donors who underwent PLDH. We describe the technical aspects and outcomes of our donor hepatectomy from assist to pure and examine the liver allograft outcomes of the recipients after LADH and PLDH. Results There was significantly less blood loss in the PLDH group (81.07 ± 52.78 g) than that in the LADH group (238.50 ± 177.05 g), although the operative time was significantly longer in the PLDH group (454.93 ± 85.60 minutes) than in the LADH group (380.40 ± 44.08 minutes). And there were no significant differences in postoperative complication rate in the 2 groups. The liver allograft outcomes were acceptable and comparable with open living donor hepatectomy. Conclusions By changing our routine approach from assist to pure, PLDH can be performed safely, with better exposure due to magnification, and with less blood loss under pneumoperitoneal pressure. PLDH, which has become our promising donor procedure, results in less blood loss, better cosmesis, and the donor's complete rehabilitation without deterioration in donor safety.

Original languageEnglish
Pages (from-to)1628-1636
Number of pages9
JournalTransplantation
Volume101
Issue number7
DOIs
Publication statusPublished - 2017 Jul 1
Externally publishedYes

ASJC Scopus subject areas

  • Transplantation

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    Takahara, T., Wakabayashi, G., Nitta, H., Hasegawa, Y., Katagiri, H., Umemura, A., Takeda, D., Makabe, K., Otsuka, K., Koeda, K., & Sasaki, A. (2017). The First Comparative Study of the Perioperative Outcomes between Pure Laparoscopic Donor Hepatectomy and Laparoscopy-Assisted Donor Hepatectomy in a Single Institution. Transplantation, 101(7), 1628-1636. https://doi.org/10.1097/TP.0000000000001675