Laparoscopic Living Donor Right Hepatectomy Regarding the Anatomical Variation of the Portal Vein: A Propensity Score–Matched Analysis

Rhu, Jinsoo; Kim, Mi Seung; Choi, Gyu‐Seong; Kim, Jong Man; Kwon, Choon Hyuck David

doi:10.1002/lt.26050

Cited by 18 publications

(41 citation statements)

References 24 publications

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“…Therefore, if the safety of the live liver donor is secured, it is desirable to perform laparoscopic surgery on the liver donor for early recovery after donor hepatectomy. In previous studies at our center, it was reported that the LDH group had smaller estimated blood loss, shorter operation time, shorter hospital stay, and similar major complication rate compared the ODH group [ 10 , 17 , 19 – 21 ].…”

Section: Discussionmentioning

confidence: 96%

“…In recent decades, LLR has been widely used by hepatobiliary surgeons, and its indication has expanded to donor hepatectomy in experienced centers. Recent studies have shown that LDH for LDLT is safe and feasible in terms of surgical outcomes compared to ODH [ 17 , 18 ]. Therefore, if the safety of the live liver donor is secured, it is desirable to perform laparoscopic surgery on the liver donor for early recovery after donor hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

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Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation

et al. 2022

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Background Laparoscopic donor hepatectomy (LDH) for living donor liver transplantation has been performed in several specialized institutes. Surgical outcomes of LDH have shown comparable results to open donor hepatectomy (ODH), but the quality of life (QOL) after LDH is not known. This prospective questionnaire-based study was performed to assess health status and QOL of live liver donors before and after donor hepatectomy (DH). Material/Methods From May 2017 to February 2020, questionnaire items such as the Enhanced Recovery after Surgery mobility scale (EMS), Body Image Questionnaire, and EQ-5D-3L were examined up to 1 year after DH to respectively evaluate postoperative recovery, body image satisfaction, and health status. Results During the study period, 45 laparoscopic DH (LDH) donors and 2 open DH (ODH) donors were finally fully evaluated. The LDH group had a significantly higher mean EMS than ODH on postoperative day (POD) 5, and 7 ( P =0.011, and P =0.004, respectively). Body image scores of the LDH group were significantly higher than that of the ODH group at 1 month after DH (17.8 vs 15.0, P =0.017). There were 45 LDH donors who recovered to preoperative values at 6 months and 1 month after DH, with no statistically significant difference in EQ-5D-3L index value and visual analogue scale ( P =0.059 and P =0.217, respectively). Conclusions Within 1 month after DH, LDH donors showed faster mobility recovery and body image satisfaction to the level of preoperative status than ODH. LDH donors recovered to preoperative health status within 6 months, in accordance with previous studies of ODH donors.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation

et al. 2022

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“…Rhu et al showed in his two publications that the median hospital stay was significantly shorter in the laparoscopy group, and there was no significant difference in the donor complications rate or severity between laparoscopic and open group or readmissions owing to complications. Also there was no significant difference in the recipient vascular and biliary complications and this resulted in equivalent 30‐day graft and patient survival 21,25 . Park et al noted that the major donor complications (G3‐5) were significantly higher in the laparoscopic group specifically in regard to bile leak and portal vein complications.…”

Section: What Are the Advantages Of Midh?mentioning

confidence: 97%

“…Also there was no significant difference in the recipient vascular and biliary complications and this resulted in equivalent 30-day graft and patient survival. 21,25 Park et al noted that the major donor complications (G3-5) were significantly higher in the laparoscopic group specifically in regard to bile leak and portal vein complications. However, when analyzed via propensity matching, there was no significant difference between the two groups.…”

Section: What Are the Advantag E S Of Midh?mentioning

confidence: 99%

Robotic donor hepatectomy: A major breakthrough in living donor liver transplantation

Bröering¹,

Sturdevant²,

Zidan³

2022

American Journal of Transplantation

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Living donation in many countries is the main resource of organs. Healthy, volunteering individuals deserve the highest safety standards possible in addition to the least invasive technique to procure the organs. Since the introduction of living donor liver transplantation, many efforts have been made to minimize the surgical trauma inherent to living donor surgery. The journey started with a large Mercedes incision and evolved to reverse L‐shaped and small upper midline incisions before the introduction of minimally invasive laparoscopic techniques originated. The technical difficulties of the laparoscopic approach due to suboptimal instrumentation, challenging ergonomics, and the long learning curve limited the application of the fully laparoscopic approach to a few centers. The recent introduction of the robotic platform with its superb optical system and advanced instruments allows for the first time, a genuine emulation of open donor surgery in a closed abdomen, thus allowing all liver donors to benefit from minimally invasive surgery (better cosmesis, less pain and morbidity, and better quality of life) without compromising donor safety. This attribute in combination with the ubiquitous presence of the robot in major transplant centers may well lead to the desired endpoint of this technology, namely, the widespread dissemination of minimally invasive donor surgery.

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“…Surgical procedures during laparoscopic donor hepatectomy are well described in our previous literature. [11,12,[15][16][17][18] Parenchymal transection was performed using ultrasonic energy devices (Sonicision [Medtronic] or Harmonic [Ethicon]). When fine delicate transection was needed, especially around the hilum, a cavitron ultrasonic surgical aspirator (CUSA EXcel [Integra]) was used.…”

Section: Establishment Of the Laparoscopy Programmentioning

confidence: 99%

Complete transition from open surgery to laparoscopy: 8‐year experience with more than 500 laparoscopic living donor hepatectomies

et al. 2022

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This study was designed to review laparoscopic living donor liver transplantations (LDLTs) at a single center that achieved complete transition from open surgery to laparoscopy. LDLTs performed from January 2013 to July 2021 were reviewed. Comparisons between open and laparoscopic surgeries were performed according to periods divided into initial, transition, and complete transition periods. A total of 775 LDLTs, 506 laparoscopic and 269 open cases, were performed. Complete transition was achieved in 2020. Bile duct variations were significantly abundant in the open group both in the initial period (30.2% vs. 8.1%; p < 0.001) and transition period (48.1% vs. 24.3%; p < 0.001). Portal vein variation was more abundant in the open group only inthe initial period (13.0% vs. 4.1%; p = 0.03). Although the donor reoperation rate (0.0% vs. 4.1%; p = 0.02) and Grade III or higher complication rate (5.6% vs. 13.5%; p = 0.03) were significantly higher in the laparoscopy group in the initial period, there were no differences during the transition period as well as in overall cases. Median number of opioids required by the donor (three times [interquartile range, IQR, 1-6] vs. 1 time [IQR, 0-3]; p < 0.001) was lower, and the median hospital stay (10 days [IQR,[8][9][10][11][12] vs. 8 days [IQR, 7-9]; p < 0.001) was shorter in the laparoscopy group. Overall recipient bile leakage rate (23.8% vs. 12.8%; p < 0.001) and overall Grade III or higher complication rate (44.6% vs. 37.2%; p = 0.009) were significantly lower in the laparoscopy group. Complete transition to laparoscopic living donor hepatectomy was possible after accumulating a significant amount of experience.Because donor morbidity can be higher in the initial period, donor selection for favorable anatomy is required for both the donor and recipient.

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Laparoscopic Living Donor Right Hepatectomy Regarding the Anatomical Variation of the Portal Vein: A Propensity Score–Matched Analysis

Cited by 18 publications

References 24 publications

Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation

Postoperative Health Status and Quality of Life After Pure Laparoscopic Donor Hepatectomy for Living Donor Liver Transplantation

Robotic donor hepatectomy: A major breakthrough in living donor liver transplantation

Complete transition from open surgery to laparoscopy: 8‐year experience with more than 500 laparoscopic living donor hepatectomies

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