Volumetric Reevaluation of Liver Left Lateral Segment Donors, Which Had Previously Been Incompatible with Intraoperative Weight Findings

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Abstract

Introduction

The aim of this study is to reevaluate the volumes of left lobe lateral segment transplant donors who have previously undergone volumetric measurement by manual method and whose results are significantly different from intraoperative weight values.

Materials and Methods

41 liver left lobe lateral segment donors were included in the study, which showed a significant discrepancy between the preoperative CT volumetric values measured by the manual method and those measured weights intraoperatively . Patients who differed by more than ten percent between the volumetric measurement and the intraoperative weight were included in the study. Surgical resection lines in control CT examinations performed in the first postoperative week and lines drawn in CT examinations performed in preoperative volumetric measurements were compared. In the patients who were found to differ between the surgical resection line and the CT line, the lateral segment volume of the left lobe was again calculated using CT manual method based on the surgical line. The measurements were made on 10 mm thick sections as in the previous CTs.

Results

When the CT scans of the liver transplant recipients were compared with those of the liver transplant donors preoperatively, we found that the line drawn during the volumetric measurement with the surgical resection line passed through different sites. Liver weights obtained intraoperatively were greater than the volumes obtained at tomography in almost all patients. The excess of liver weights varied between 26-178 grams. The average of the weight difference obtained intraoperatively with the lateral segment volume of the left lobe was 71.3 gram. In the volumetric measurements made by considering the surgical resection line, the average of the difference between the resected liver weight and the liver volume measured by manual method was found to be 20.7 gram.

Conclusion

We think that the big difference between the volumetric measurement and the intraoperative liver weight is caused by the fact that the line drawn by the surgical resection line and the line drawn by CT are passing through different planes. In order to minimize this error, the radiologist measuring the volume and the surgeon performing the resection must work in coordination and the surgeon must direct the radiologist as needed.

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