Pure Laparoscopic versus Open Right Hepatectomy in Live Liver Donors: A Propensity Score Matched Analysis

Hong, Suk Kyun; Tan, Melin; Worakitti, Lapisatepun; Lee, J.-M.; Cho, J.-H.; Yi, Nam‐Joon; Lee, K.-W.; Suh, Kyung‐Suk

doi:10.1016/j.hpb.2020.11.255

Cited by 7 publications

(20 citation statements)

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“…Korean multicentre study included in the qualitative data synthesis did not compare PLDH and ODH. [ 14 ] Hence, three studies published from Korean centres (SMC, SNUH and SNUBH) which reported on comparative data between PLDH and ODH[ 38 39 40 ] were included in the meta-analysis. Hence, in total six studies were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Four studies[ 16 38 39 40 ] reported on the estimated blood loss, which was less in the PLDH group (361 patients) when compared with the ODH group (626 patients) (weighted mean difference [WMD] −106.93; 95% confidence interval [CI] −215.64–1.78), but this did not reach statistical significance ( P = 0.05) [ Figure 2a ]. The statistical heterogeneity of the studies was 'substantial' ( I 2 : 89%).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies[ 16 19 38 39 40 ] reported on the length of stay (LOS), which was less by a mean of nearly one day in the PLDH group (366 patients) when compared with the ODH group (636 patients) [WMD − 0.73; 95% CI − 1.34,-0.12; P = 0.02] [ Figure 2b ]. The statistical heterogeneity of the studies was 'substantial' (I 2: 74%).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies reported on overall morbidity and major complications, but this was no difference between the two groups[ 16 19 38 39 40 ] [Figure 2c and d ]. The statistical heterogeneity of the studies was 'not important' (I 2: 0%) for both the comparisons [Supplementary Figure and Supplementary Figure ].…”

Section: Resultsmentioning

confidence: 99%

“…In the propensity score-matched analysis of Hong et al ., the PLDH group included patients operated after March 2016, excluding the initial cases done to accumulate experience. [ 39 ] Moreover, our study included cases of PLDH for adult LDLT, excluding other minimally invasive approaches, hand-assisted and hybrid techniques. Comparisons were only made between pure laparoscopic and ODH as that is currently the standard practice.…”

Section: Discussionmentioning

confidence: 99%

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Pure laparoscopic versus open donor hepatectomy for adult living donor liver transplantation – A systematic review and meta-analysis

Papoulas

Hakeem

Heaton

et al. 2022

Journal of Minimal Access Surgery

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Background: Pure laparoscopic donor hepatectomy (PLDH) for adult living donor liver transplantation (LDLT) remains controversial. The aim of this study was to undertake a systematic review and meta-analysis of donor outcomes following PLDH for adult LDLT. Materials and Methods: Systematic review in line with the meta-analysis of observational studies in epidemiology guidelines. Results: Eight studies were included in the systematic review and six in the meta-analysis. A total of 575 donors underwent PLDH for adult LDLT. The mean donor age was 32.8 years with a BMI of 23.4 kg/m 2 and graft weight of 675 g. The mean operative time was 353 min and the conversion rate was 2.8% ( n = 16). Overall morbidity was 10.8% with 1.6% major complications (Clavien-Dindo grade 3b), zero mortality and 9.0 days length of stay (LOS). The meta-analysis demonstrated that the operative time was significantly shorter for the open donor hepatectomy group (mean difference 29.15 min; P = 0.006) and the LOS was shorter for the PLDH group (mean difference −0.73 days; P = 0.02), with a trend towards lesser estimated blood loss in PLDH group. However, no difference between the two groups was noted in terms of overall morbidity or major complications. Conclusions: Perioperative outcomes of PLDH are similar to the standard open approach in highly specialised centers with trend towards lesser blood loss and overall shorter hospital stay. Careful donor selection and standardisation of the technique are imperative for the successful implementation and adoption of the procedure worldwide.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Pure laparoscopic versus open donor hepatectomy for adult living donor liver transplantation – A systematic review and meta-analysis

Papoulas

Hakeem

Heaton

et al. 2022

Journal of Minimal Access Surgery

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Anatomical classification and clinical outcomes of biliary strictures in living donor liver transplantation using right liver grafts

Park

Han

Park

et al. 2022

Liver Transplantation

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This study aimed to classify the anatomical types of biliary strictures, including intrahepatic biliary stricture (IHBS), after living donor liver transplantations (LDLTs) using right liver grafts and evaluate their prognosis. Among 692 adult patients who underwent right liver LDLT, 198 recipients with biliary strictures (28.6%) were retrospectively reviewed. Based on data obtained during the first cholangiography, the patients' biliary strictures were classified into the following three types according to the levels and number of branches involved: Types 1 (anastomosis), 2 (second-order branch [a, one; b, two or more; c, extended to the third-order branch]), and 3 (whole graft [a, multifocal strictures; b, diffuse necrosis]). IHBS was defined as a nonanastomotic stricture. Among the 198 recipients with biliary strictures, the IHBS incidence rates were 38.4% (n = 76).The most common type of IHBS was 2c (n = 43, 56.6%), whereas Type 3 (n = 10, 13.2%) was uncommon. The intervention frequency per year significantly differed among the types (Type 1, 2.3; Type 2a, 2.3; Type 2b, 2.8; Type 2c, 4.3; and Type 3, 7.2; p < 0.001). The intervention-free period for more than 1 year, which was as follows, also differed among the types: Type 1, 84.4%; Type 2a, 87.5%; Type 2b, 86.7%; Type 2c, 72.1%; and Type 3, 50.0% (p = 0.048). The graft survival rates of Type 3 (80.0%) were significantly lower than those of the other types (p = 0.001). IHBSs are relatively common in right liver LDLTs. Although Type 3 IHBSs are rare, they require more intensive care and are associated with poorer graft survival rates than anastomosis strictures and Type 2 IHBS.

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Influence of Large Grafts Weighing ≥ 1000 g on Outcome of Pure Laparoscopic Donor Right Hepatectomy

Lapisatepun

Hong

et al. 2021

Journal of Gastrointestinal Surgery

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Pure Laparoscopic versus Open Right Hepatectomy in Live Liver Donors: A Propensity Score Matched Analysis

Cited by 7 publications

References 0 publications

Pure laparoscopic versus open donor hepatectomy for adult living donor liver transplantation – A systematic review and meta-analysis

Pure laparoscopic versus open donor hepatectomy for adult living donor liver transplantation – A systematic review and meta-analysis

Anatomical classification and clinical outcomes of biliary strictures in living donor liver transplantation using right liver grafts

Influence of Large Grafts Weighing ≥ 1000 g on Outcome of Pure Laparoscopic Donor Right Hepatectomy

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