Laparoscopic assisted donor hepatectomy is it possible is it safe
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Laparoscopic-assisted donor hepatectomy: is it possible?, is it safe?. Barros Schelotto Pablo , Pfaffen Guillermo, Ramisch Diego, Padín Juan, Sandi Marcelo, Farinelli Pablo, Rumbo Carolina, Descalzi Valeria, Trentadue Julio, Niveiro Silvia, Raffa Sebastián, Gondolesi Gabriel.

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Laparoscopic-assisted donor hepatectomy: is it possible?, is it safe?

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Laparoscopic assisted donor hepatectomy is it possible is it safe

Laparoscopic-assisted donor hepatectomy: is it possible?, is it safe?

Barros Schelotto Pablo, Pfaffen Guillermo, Ramisch Diego, Padín Juan, Sandi Marcelo, Farinelli Pablo, Rumbo Carolina, Descalzi Valeria, Trentadue Julio, Niveiro Silvia, Raffa Sebastián, Gondolesi Gabriel.

INSTITUTO DE TRASPLANTE MULTIORGÁNICO

HOSPITAL UNIVERSITARIO

FUNDACIÓN FAVALORO

Buenos Aires - Argentina


Laparoscopic assisted donor hepatectomy is it possible is it safe

Background

  • Laparoscopic liver resection has evolved in the last decade.

  • Favorable outcomes increased the interest to perform this technique in living donors for liver transplantation.

  • Few liver transplant centers have developed the laparoscopic living donor hepatectomy (LLDH)


Laparoscopic assisted donor hepatectomy is it possible is it safe

.

Aim

  • To present the first experience of video-assisted hepatectomy in living donors for pediatric liver transplantation performed in 3 consecutive donors in Argentina

  • To report safety and feasibility of the procedure.


Laparoscopic assisted donor hepatectomy is it possible is it safe

Procedure

1.Laparoscopic-assisted stage: includes liver mobilization, intraoperative cholangiography and doppler ultrasound, hepatic hilar and left hepatic vein dissection followed by the beginning of the parenchymal transection 2.Open stage: includes completion of the parenchymal transection throughout the hand port incision. Harvesting of the liver, suture of the remnant vascular and biliary stumps


Laparoscopic assisted donor hepatectomy is it possible is it safe

All were isogroup for blood type and had no biochemical abnormalities. Anatomical evaluations were done on a 64 heads multi-detector CT scan In the recipient a total hepatectomy with preservation of cava vein was performed.Hepatic, portal, arterial and biliary Roux-Y reconstruction were performed in standard fashion. .

Donors evaluation

Recipient


Laparoscopic assisted donor hepatectomy is it possible is it safe

Results

Two left lateral segmentectomy and one left hepatectomy were performed.

The mean donor’s age was 31.3 years all donors were female.

All patients started oral intake on the next day of surgery.


Laparoscopic assisted donor hepatectomy is it possible is it safe

Results

.No donors had early or late complications after 14 m.


Video assisted hepatectomy had the advantages of minimally invasive surgery

Video-assisted hepatectomy had the advantages of minimally invasive surgery.

Conclusion

  • Based on the results reported by international literature and the results presented in this series, we considerer that, LLDH might become the standard procedure in centers with experience in laparoscopic liver resection.


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