Outcome of Right Hepatectomy for Living Liver Donors: A Single Egyptian Center Experience

Salah, Tarek; Sultan, Ahmed; Fathy, Omar; Elshobary, Mohammed M.; El-Ghawalby, Nabih; Yassen, Amr M.; Elsarraf, Walid M. R.; Elmorshedi, Mohammed; Elsaadany, Mohammed F; Shiha, Usama; Wahab, Mohamed Abdel

doi:10.1007/s11605-012-1851-4

Cited by 29 publications

(30 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Readmission rates did not differ between the 2 groups ( P = 0.70). We had 1 case of donor mortality, which was previously described in detail …”

Section: Resultsmentioning

confidence: 99%

“…The institutional review board of the Gastroenterology Surgical Center approved the protocol of the study. The donor preparation scheme, exclusion criteria, and details of the surgical technique have previously been reported . All of our potential donors were evaluated with magnetic resonance cholangiography (MRC) to ascertain the number of graft ducts.…”

Section: Methodsmentioning

confidence: 99%

“…Multiple small ducts make the biliary reconstruction more difficult and may influence the outcome in the recipient . Also, it may lead to injury of the donor's biliary system, with subsequent early or late complications . Biliary leakage, bilomas, and biliary strictures are well recognized donor complications that may be directly linked to bile duct division.…”

mentioning

confidence: 99%

“…3,4 Also, it may lead to injury of the donor's biliary system, with subsequent early or late complications. 5,6 Biliary leakage, bilomas, and biliary strictures are well recognized donor complications that may be directly linked to bile duct division. Biliary complications constitute the majority of the clinically significant donor complications in many reports.…”

mentioning

confidence: 99%

“…Biliary complications constitute the majority of the clinically significant donor complications in many reports. 1,5,[7][8][9] Abbreviations: BMI, body mass index; CHD, common hepatic duct; EDG, extrahepatic dissection group; ERCP, endoscopic retrograde cholangiopancreatography; ES, endoscopic stenting; ESLD, end-stage liver disease; FGG, fluoroscopy-guided transection group; GRWR, graft-to-recipient weight ratio; LDLT, living donor liver transplantation; LHD, left hepatic duct; MRC, magnetic resonance cholangiography; RHD, right hepatic duct; S4, segment 4; USTD, ultrasound-guided tube drainage.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Biliary complications in living donor right hepatectomy are affected by the method of bile duct division

et al. 2014

Self Cite

View full text Add to dashboard Cite

The bile duct division is a crucial step in the donor hepatectomy. Multiple small ducts will make the biliary reconstruction more difficult and may influence the outcome of the recipient. Biliary leakage, bilomas and biliary strictures are well recognized donor complications that may be directly linked to bile duct division. Biliary division still needs more standardization. This work aims to analyze our experience with two different methods of bile duct division in relation to the development of intraoperative and postoperative biliary complications. Between April 2004 and March 2013, 216 liver donors underwent right hepatectomy, in Gastro-Enterology Surgical Center, Mansoura University, Egypt. According to the method of bile duct division, the study population was divided into 2 groups; 1-extrahepatic dissection group (EDG) and 2-fluoroscopy guided transection group (FGG), each comprised 108 patients. Data were collected from a prospectively registered database, with special emphasis on the occurrence of biliary complications. Complications were classified according to the latest version of Clavien classification. Intraoperative biliary complications did not differ between both groups, p 5 0.313. The commonest postoperative complication was biliary leak/biloma accounting for 32.5% of all donor complications, followed by non-biliary fluid collections. 24 (11.1%) donors developed 27 biliary complications. The FGG showed significantly less biliary complications (5.6%, 6 donors), when compared to EDG (15.7%, 18 donors), p 5 0.015. Grade 3 complications were significantly higher in EDG, p 5 0.024. On multivariate analysis, the only significant factor predicting the occurrence of biliary complications was the use of fluoroscopy guided bile duct division, p 5 0.009. In conclusion, we believe that the proposed method of biliary division is safe, simple and reproducible.

show abstract

“…Readmission rates did not differ between the 2 groups ( P = 0.70). We had 1 case of donor mortality, which was previously described in detail …”

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Biliary complications in living donor right hepatectomy are affected by the method of bile duct division

et al. 2014

Self Cite

View full text Add to dashboard Cite

show abstract

Impact of donor‐recipient genetic relationship on outcome of living donor liver transplantation

et al. 2016

Self Cite

View full text Add to dashboard Cite

Living donor liver transplantation (LDLT) is flourishing in localities where deceased organ donation is prohibited or not favored due to religious, cultural, or legal issues. (1) It is hypothesized that LDLT has an immunological advantage over deceased donor liver transplantation (DDLT) due to the fact that most LDLT is done among genetically related (GR) donor-recipient pairs.(2) However, the difference in ischemia time, the quality of the graft, and the age of the donor may be confounding factors that make the comparison inaccurate.(2,3) To understand the impact of genetic relation on the outcome of liver transplantation, LDLT is a perfect model because grafts are procured from both GR and genetically unrelated (GUR) donors.Unlike renal transplantation, current practice does not consider human leukocyte antigen (HLA) matching as a basic step in liver transplantation based on the apparent absence of hyperacute rejection and the infrequent early graft loss from rejection.(4) However, its impact on graft survival, immunosuppressive regimen, and patient outcome have been warranted in further research.(5) Multiple studies investigated the effect of HLA mismatching on graft and recipient outcomes.(5-7)

show abstract

Ligation and cut as a method for bile duct division in living donor right hepatectomy

Kim

Lee

et al. 2017

Liver Transpl

View full text Add to dashboard Cite

The importance of bile duct division cannot be overemphasized in living donor surgery. Ligation and cut (LC) as a method for bile duct division in living donor right hepatectomy (LDRH) has never been reported. The purpose of this study was to introduce the LC method of bile duct division in LDRH. All LDRH donors were identified through a prospectively maintained database at the authors' institution between September 2009 and March 2013, and the 2 methods, LC and cut and oversewing (CO), were compared both in terms of donor and recipient outcomes of right lobe living donor liver transplantation. In the LC method, after complete parenchymal transection, the right hepatic duct was dissected in the Glisson's sheath and ligated just at the right side of the confluence, and then the right side of the ligature was cut. The LC and CO methods were performed in 109 and 134 donors, respectively. Bile duct division time (P < 0.001) and operative time (P < 0.001) were significantly shorter in the LC group than in the CO group. With a median follow-up of 60.2 months, biliary complication rate was lower in the LC group than in the CO group (0% versus 5.2%; P = 0.01), but with no significant difference between the recipient groups. All donors made a complete recovery. In conclusion, the bile ducts of living donors can be dissected safely from the Glisson's sheath, and the LC method facilitates bile duct division and has a lower incidence of biliary complication in LDRH without compromising the recipient outcomes. Liver Transplantation 23 448-456 2017 AASLD.

show abstract

Outcome of Right Hepatectomy for Living Liver Donors: A Single Egyptian Center Experience

Abstract: Donor right hepatectomy is not an entirely safe procedure. Biliary complications are the commonest early postoperative complications.

Cited by 29 publications

References 31 publications

Biliary complications in living donor right hepatectomy are affected by the method of bile duct division

Biliary complications in living donor right hepatectomy are affected by the method of bile duct division

Impact of donor‐recipient genetic relationship on outcome of living donor liver transplantation

Ligation and cut as a method for bile duct division in living donor right hepatectomy

Contact Info

Product

Resources

About