From the left to the right: 13-year experience in laparoscopic living donor liver transplantation

被引：15
作者：
Brustia R. [1 ,3 ]
Komatsu S. [1 ]
Goumard C. [1 ,3 ]
Bernard D. [1 ]
Soubrane O. [2 ,4 ]
Scatton O. [1 ,3 ]
机构：
[1] Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, 47-83 Boulevard de l’Hôpital, Paris
[2] Department of Hepatobiliary Surgery and Liver Transplantation, Hôpital Beaujon, Assistance Publique-Hôpitaux de Paris, 100 Boulevard du Général Leclerc, 92110, Clichy
[3] Université Pierre et Marie Curie, Paris
[4] Université Diderot, Paris
来源：
Updates in Surgery | 2015年 / 67卷 / 2期
关键词：
Donor safety; Laparoscopy; Living donor liver transplantation; Minimally invasive liver surgery; Two senior surgeons;
D O I：
10.1007/s13304-015-0309-0
中图分类号：
学科分类号：
摘要：
Living Donors are the best theoretical candidates to benefit from the advantages of laparoscopy, but development was slow because of concerns about graft integrity and donor safety. Herein our 13-year experience in laparoscopic Living Donor Liver Transplantation (LDLT) is presented. Laparoscopic Left Lateral Section (LLLS) was performed in children receiver, while Laparoscopic Left Hepatectomy (LLH)—including or not the middle hepatic vein—and Laparoscopic Right Hepatectomy (LRH) in adults. Two senior surgeons were always involved for each procedure. All donors were first-degree relatives. From 2001 to 2014, 71 procedures were performed: 63 LLLS (88.7 %, 6 LLH (8.4 %), and 2 LRH (2.8 %). Surgical procedures required a mean of 271.1 ± 65.9, 318 ± 40.2, and 480 ± 0 min for LLLS, LLH, and LRH, respectively with a learning curve toward LLLH over the years (r = 0.09). Seven procedures (9.8 %) required conversion. The mean hospital stay was 5.5 ± 3.4, 5.3 ± 0.6, and 8 ± 0 days for LLLS, LLH, and LRH, respectively. Complications occurred in 11 patients (17.3 %) undergoing LLLS: 8 (12.7 %) grade I and 3 (4.7 %) grade II, according to the Modified Clavien–Dindo classification. Laparoscopic liver resection for LDLT requires an equivalent and parallel expertise in open LDLT and LLR. If LLLS for LDLT is now in an exploration phase in highly specialized centers, LLH and LRH for LDLT in adults lack evidence and cannot be recommended for wide introduction. For laparoscopic LDLT beginners, LLLS offers optimal conditions. © 2015, Italian Society of Surgery (SIC).
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页码：193 / 200
页数：7
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