Abstract
Laparoscopy-assisted Donor Hepatectomy
Dr Go Wakabayashi
Professor and Chairman, Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan
Background/Aims:
Since 1995, we have accumulated 110 patients for living donor liver transplantation (LDLT) and 170 patients who underwent laparoscopic liver resection. The aim of this study is to standardize basic skills and to establish safer technique for laparoscpic liver resection in order to perform safe laparoscopic donor hepatectomy.
Methods:
We analyzed initial results from the point of operative techniques for laparoscopic liver resection of our series. Based on the success of our first case and our experience of laparoscopic liver resection, we started laparoscopy-assisted donor hepatectomy program from July 2007 and accumulated ten cases by July 2008. We reviewed our initial results of these ten cases.
Results:
Ten grafts include six right lobes and two left lobes for adults and two lateral sectors for children. All procedures of ten laparoscopy-assisted donor hepatectomies were smooth and uneventful, and there is no conversion to open surgery since the program started. Mean operative time was 401 minutes (ranging from 330 to 510 minutes). Mean blood loss was 230 ml (ranging from 52 to 425 ml). Graft weight ranged from 194 to 740 g. All donors started oral intake on the next day of the surgery and went back home by the eighth post-operative day without having any complication. Graft function was well in all recipients. No recipient had any complication related to the graft surgery including bleeding, hepatic artery thrombosis, and bile leakage.
Conclusions:
Laparoscopy-assisted donor hepatectomy is safe and feasible with mini-laparotomy. To minimize the burden imposed on living donors, we will continue this laparoscopy-assisted donor hepatectomy program for every living donor liver transplantation.
