Result: During the study period, 15 donors with RPV variations underwent pure laparoscopic living donor right hemi-hepatectomy. 4 donors (26.7%) had type II portal vein, 7 donors (46.7%) had type III portal vein, and 4 donors (26.7%) had type IV portal vein. Multiple right hepatic ducts were encountered in 13 donors (86.7%). No open conversions or peri-operative blood transfusion were required. Post-operative morbidity occurred in one donor (6.7%), in the form of cystitis. No postoperative biliary or vascular complications occurred. No readmissions were required during the follow up. Conclusion: The current series proves the safety and feasibility of laparoscopic approach for donors with RPV variations. This series is a step towards further expansion of the current indications of laparoscopic adult living donor hepatectomy.

Ewing's sarcoma is a highly aggressive malignant tumour most commonly affecting long bones in children and adolescents. It is part of the Ewing's sarcoma family of tumours (ESFTs) that also include peripheral primitive neuroectodermal tumour and Askin's tumours. ESFTs share common cytogenetic aberrations, antigenic profiles and proto-oncogene expression with an overall similar clinical course. In 99% of ESFTs, genetic translocation with molecular fusion involves the EWSR1 gene on 22q12. Approximately 30% of ESFTs are extraosseous, most commonly occurring in the soft tissues of extremities, pelvis, retroperitoneum and chest wall. Primary presentation in solid organs is very rare but has been described in multiple sites including the pancreas. Accurate diagnosis of a Ewing's sarcoma in a solid organ is critical in facilitating correct treatment. We report the case of a 17-year-old girl with cytogenetically confirmed primary pancreatic Ewing's sarcoma and provide a brief review of the published literature.

HighlightsA rare hepatic venous variation in the voluntary liver donor and the surgical challenge faced by the transplant surgeon.Review of the variations of hepatic venous drainage and their significance in the context of living donor liver transplantation.Surgical maneuver employed in dealing with such a rare variation of hepatic vein in the living donor.

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BACKGROUNDHealth-related quality of life (HRQOL) is an important measure of the effects of end stage liver disease in affected patients that helps to improve well-being after Liver transplantation (LT). One study has been performed to access HRQoL pre and post liver transplant (LT) patients in India. Our study was aimed to determine HRQoL in pre and post orthotopic liver transplant (OLT) with correlation between severity of liver disease by Model for End-Stage Liver Disease (MELD)/Child-Turcotte-Pugh (CTP) score and Diabetes Mellitus (DM) status with HRQoL post OLT. METHODSStudy was designed as a single center, observational, prospective and longitudinal study. HRQoL was evaluated by SF-36 questionnaire in sixty (50 male and 10 female with average age of 45 years) patients with end stage liver disease; having HCV related cirrhosis with alcoholic and cryptogenic liver disease forming the second and third largest groups respectively. HRQoL was evaluated pre and post OLT also correlation of MELD/CTP scores and diabetes status with post-OLT HRQoL was determined. Patients were followed up for a period of 3 months after OLT. RESULTSPost OLT patients had higher scores in comparison to pre OLT. There was a signi cant difference in all eight domains of the SF-36 scores (p < 0.001) post OLT. Negative correlation was observed between MELD/CTP scores and HRQoL post OLT with signi cance in the domain of vitality and mental component summary in MELD and physical functioning in CTP (p < 0.05). Diabetes did not exert any signi cant effect on HRQoL. CONCLUSIONSOLT have an improved HRQoL when compared to their pre transplant status. MELD/CTP scores were not predictive of HRQoL post OLT, while DM status did not exhibit any effect on HRQoL after OLT.