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Pure 3D laparoscopy versus open right hemihepatectomy in a donor with type II and III portal vein variations
Ann Hepatobiliary Pancreat Surg 2019 Nov;23(4):313-8
Published online November 30, 2019;  https://doi.org/10.14701/ahbps.2019.23.4.313
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Kyungho Park1,*, Ahmed Shehta1,2,*, Jeong-Moo Lee1, Suk Kyun Hong1, Kyung Chul Yoon3, Jae-Hyung Cho1, Nam-Joon Yi1, Kwang-Woong Lee1, and Kyung-Suk Suh1

1Department of Surgery, Seoul National University College of Medicine, Seoul, Korea, 2Liver Transplantation Unit, Gastrointestinal Surgery Center, College of Medicine, Mansoura University, Mansoura, Egypt, 3Department of Surgery, Korea University College of Medicine, Seoul, Korea
Received April 13, 2019; Revised October 8, 2019; Accepted October 23, 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: Pure laparoscopic living donor right hemihepatectomy (PLDRH) has been performed in many experienced centers. However, portal vein variations still remain challenging thus disturbing the widespread of PLDRH in many centers. PLDRH when integrated with 3-dimensional laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography is safe and feasible.
Methods: We reviewed 19 donors with separated right anterior and right posterior portal veins who underwent living donor right hemihepatectomy between January 2014 and December 2016. We compared the clinical outcomes of PLDRH and conventional open right hemihepatectomy (CDRH).
Results: 6 donors (31.6%) underwent PLDRH while 13 donors (68.4%) underwent CDRH. There was no intraoperative complications, transfusions and open conversions in the PLDRH donors. The total operative time was longer in PLDRH (356.5 vs. 244.5 minutes, p=0.003). However, the length of hospital stay (8.5 vs. 9.0 days, p=0.703), blood loss (450.0 vs. 393.6 ml, p=0.557) and complication rate (16.6% vs.27.3%; p=0.327) did not differ between the two groups.
Conclusions: PLDRH is safe and feasible in donors with type II and III portal vein variations. Further prospective comparative studies are needed to prove the safety and efficacy of PLDRH.
Keywords : Portal vein variations; Pure laparoscopic donor hepatectomy; Open donor hepatectomy

 

November 2019, 23 (4)