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Comparison of liver regeneration in laparoscopic versus open right hemihepatectomy for adult living donor liver transplantation
Ann Hepatobiliary Pancreat Surg 2020 Feb;24(1):33-7
Published online February 29, 2020;  https://doi.org/10.14701/ahbps.2020.24.1.33
Copyright © 2020 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Jaehun Yang, Jong Man Kim, Jinsoo Rhu, Sangjin Kim, Seohee Lee, Gyu-Seong Choi, and Jae-Won Joh

Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Received November 14, 2019; Revised November 16, 2019; Accepted November 18, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: This study aims to compare differences between laparoscopic donor right hemihepatectomy (LDRH) and open donor right hemihepatectomy (ODRH) in the quality of the operation, postoperative complications, and liver regeneration measured via volumetry.
Methods: This study included 119 patients who underwent living donor right hemihepatectomy at Samsung Medical Center from January 2016 to December 2017. We compared several aspects of LDRH and ODRH and analyzed the results using the independent t-test, chi-square test and Fisher’s exact test.
Results: Among 119 enrolled patients, 66 patients (55.5%) underwent open surgery, and 53 patients (44.5%) underwent laparoscopic surgery. The mean operation time was significantly shorter for ODRH (290.57±54.04 minutes) than LDRH (312.28±53.5 minutes) (p=0.031). Estimated blood loss was significantly less in LDRH (258.49±119.99 ml) than ODRH (326.52±157.68 ml) (p=0.011). The remnant liver recovered to 83.35±10.71% of the preoperative estimate whole liver volume (pre-EWLV) in the ODRH group and 84.04±8.98% of the pre-EWLV in the LDRH group (p=0.707). The percentage of increased estimated liver volume to postoperative estimate remnant liver volume (post-ERLV) was 137.62±40.34% in the ODRH group and 130.56±36.78% in the LDRH group, and there was no statistically significant difference between the two groups (p=0.326). An analysis of postoperative complications showed no significant differences.
Conclusions: LDRH is safe, and there is no significant difference in hepatic regeneration compared with ODRH. Therefore, LDRH can be applied for living donation of liver.
Keywords : Living donor right hemihepatectomy; Laparoscopic donor right hemihepatectomy; Liver transplantation; Liver regeneration; Volumetry