Comparative Study of Pure Laparoscopic Donor Right Hemihepatectomy and Open Donor Right Hemihepatectomy in Patients with Separate Right Anterior and Right Posterior Portal Veins

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Abstract

Introduction

Pure laparoscopic living donor right hemihepatectomy (PLDRH) has been performed in several experienced center. But, Anatomical variation of portal veins still could be one of the reasons for the hesitation to perform PLDRH. We reported that pure laparoscopic donor right hemihepatectomy; integrated with 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography is safe and good modality for patients had separate right anterior and right posterior portal veins.

Method

We performed living donor right hemihepatectomy in 19 donors who had separated right anterior and right posterior portal veins between January 2014 and December 2016. We excluded 2 laparoscopic assisted hepatectomy cases and compared the clinical outcomes of pure laparoscopic donor right hemihepatectomy (PLDRH) and conventional open right hemihepatectomy (CDRH) groups.

Results

None of the 6 PLDRH donors had intraoperative complications and none required transfusions, reoperation, or conversion to open hepatectomy. The total operative time was longer (356.5 vs. 244.5 minutes; P=0.003). However, the length of postoperative hospital stay (8.5 vs. 9.0 days; P=0.703) and blood loss (450.0 vs. 393.6 ml; P=0.557) and complication rate (33.3% vs. 27.3%; P=0.515) were similar in both groups.

Conclusion

Pure 3D laparoscopic living donor right hemihepatectomy is feasible in a donor with separate right anterior and right posterior portal veins.

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