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One Hundred Fifteen Cases of Pure Laparoscopic Living Donor Right Hepatectomy at a Single Center
- Source :
- Transplantation. 102:1878-1884
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- The pure laparoscopic approach to donor hepatectomy is being taken more often. However, few centers perform pure laparoscopic donor right hepatectomy (PLDRH) because it requires a high level of surgical skill. Studies reporting initial outcomes of PLDRH may prompt further implementation of the technique and help reduce initial learning curves at other transplant centers. This study reports performance of PLDRH at a single center with extensive experience of adult living donor liver transplantation.Data from 115 donors (and recipients) who underwent PLDRH between November 2015 and June 2017 were analyzed retrospectively. Subgroup analysis was performed to compare outcomes between the initial (November 2015 to October 2016) and more recent (November 2016 to June 2017) periods.During the initial period, 3 (2.6%) donors experienced complications greater than grade III on the Clavien-Dindo scale. By contrast, no donors developed complications during the recent period. The operative time (293.6 minutes vs 344.4 minutes; P0.001) and hospital stay (7.3 days vs 8.3 days; P = 0.002) were significantly shorter during the more recent period. Also, Δhemoglobin (Hb)%, calculated as ΔHb% = [(preoperative Hb - postoperative Hb)/preoperative Hb] × 100 (14.9% vs 17.5%; P = 0.042), and Δaspartate aminotransferase (AST)%, calculated as ΔAST% = [(peak AST - preoperative AST)/preoperative AST] × 100 (1048.9% vs 1316.6%; P = 0.009), were significantly lower during the recent period.Pure laparoscopic donor right hepatectomy is both feasible and safe when performed at a center experienced in adult living donor liver transplantation. Performance of about 60 PLDRHs over 1 year is sufficient to standardize the procedure.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Seoul
medicine.medical_treatment
Operative Time
030230 surgery
Single Center
Living donor
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Risk Factors
Living Donors
medicine
Surgical skills
Hepatectomy
Humans
Young adult
Retrospective Studies
Donor hepatectomy
Transplantation
business.industry
Retrospective cohort study
Length of Stay
Middle Aged
Liver Transplantation
Surgery
Treatment Outcome
Operative time
Female
Laparoscopy
030211 gastroenterology & hepatology
Clinical Competence
business
Learning Curve
Subjects
Details
- ISSN :
- 15346080 and 00411337
- Volume :
- 102
- Database :
- OpenAIRE
- Journal :
- Transplantation
- Accession number :
- edsair.doi.dedup.....47bd295537004a8aa103bfeadb746dbb