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Donor body mass index over 30 is no barrier for pure laparoscopic donor right hepatectomy
Ann Hepatobiliary Pancreat Surg
Published online April 3, 2024;  https://doi.org/10.14701/ahbps.24-020
Copyright © 2024 The Korean Association of Hepato-Biliary-Pancreatic Surgery.

Suk Kyun Hong, Minseob Kim, Youngjin Kim, Jae-Yoon Kim, Jaewon Lee, Jiyoung Kim, Su Young Hong, Jeong-Moo Lee, YoungRok Choi, Nam-Joon Yi, Kwang-Woong Lee, Kyung-Suk Suh

Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
Correspondence to: Suk Kyun Hong, MD, PhD
Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
Tel: +82-2-2072-4318, Fax: +82-2-766-3975, E-mail: nobel1210@naver.com
ORCID: https://orcid.org/0000-0002-0020-6215
Received January 22, 2024; Revised March 11, 2024; Accepted March 12, 2024.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Challenges arise when translating pure laparoscopic donor right hepatectomy (PLDRH) results from Asian to Western donors, due to differences in body mass index (BMI). This study compares the outcomes of PLDRH and conventional open donor right hepatectomy (CDRH) in donors with BMI over 30.
Methods: Medical records of live liver donors (BMI > 30) undergoing right hepatectomy (2010−2021) were compared: 25 PLDRH cases vs. 19 CDRH cases. Donor and recipient demographics, operative details, and outcomes were analyzed.
Results: PLDRH and CDRH had similar donor and recipient characteristics. PLDRH had longer liver removal and warm ischemic times, but a shorter post-liver removal duration than CDRH. Donor complication rates were comparable, with the highest complication being grade IIIa in PLDRH, necessitating needle aspiration for biloma on postoperative day 11. Fortunately, this donor fully recovered without additional treatment. No complications exceeding Clavien–Dindo grade IIIa occurred in either group. Recipient outcomes between the groups were similar.
Conclusions: This study supports PLDRH as a viable option for donors with BMI over 30, challenging the notion that high BMI should deter considering PLDRH. The findings provide valuable insights into the safety and feasibility of PLDRH, encouraging further exploration of this technique in diverse donor populations.
Keywords : Living donor; Laparoscopy; Hepatectomy; Body mass index; Safely