Laparoscopy-Assisted versus Open Hepatectomy for Live Liver Donor: Systematic Review and Meta-Analysis

Zhang, Bin; Pan, Yu; Chen, Ke; Maher, Hendi; Chen, Mingyu; Zhu, Hepan; Zhu, Yibin; Dai, Yi; Chen, Jiang; Cai, Xiujun

doi:10.1155/2017/2956749

Cited by 26 publications

(32 citation statements)

References 22 publications

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“…Donor and recipient outcomes of hybrid and mini-laparotomy approaches are summarized in Tables 1 and 2 , respectively. Although inconsistently reported in case series, the benefits of reduced blood loss, wound pain and overall morbidity have been concluded in a meta-analysis comparing RW donor hepatectomy and open donor hepatectomy[ 57 ]. Types of complications were not specified.…”

Section: Present Statusmentioning

confidence: 99%

Minimally invasive donor hepatectomy, are we ready for prime time?

Chok

2018

WJG

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Minimally invasive surgery potentially reduces operative morbidities. However, pure laparoscopic approaches to donor hepatectomy have been limited by technical complexity and concerns over donor safety. Reduced-wound donor hepatectomy, either in the form of a laparoscopic-assisted technique or by utilizing a mini-laparotomy wound, i.e., hybrid approach, has been developed to bridge the transition to pure laparoscopic donor hepatectomy, offering some advantages of minimally invasive surgery. To date, pure laparoscopic donor left lateral sectionectomy has been validated for its safety and advantages and has become the standard in experienced centres. Pure laparoscopic approaches to major left and right liver donation have been reported for their technical feasibility in expert hands. Robotic-assisted donor hepatectomy also appears to be a valuable alternative to pure laparoscopic donor hepatectomy, providing additional ergonomic advantages to the surgeon. Existing reports derive from centres with tremendous experience in both laparoscopic hepatectomy and donor hepatectomy. The complexity of these procedures means an arduous transition from technical feasibility to reproducibility. Donor safety is paramount in living donor liver transplantation. Careful donor selection and adopting standardized techniques allow experienced transplant surgeons to safely accumulate experience and acquire proficiency. An international prospective registry will advance the understanding for the role and safety of pure laparoscopic donor hepatectomy.

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Section: Present Statusmentioning

confidence: 99%

Minimally invasive donor hepatectomy, are we ready for prime time?

Chok

2018

WJG

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“…Hand-assisted or hybrid donor hepatectomy has the same principles as pure laparoscopic donor hepatectomy, but the hepatic hilum is dissected and the liver is transected through a small open upper midline or transverse incision [34,68] . Similarly, the muscle layer is not interrupted, and, as a result, patients feel less abdominal wall pain than with the open hepatectomy [69] . However, the small incision of these techniques has drawbacks for obese patients with deep body cavities, such as longer operative duration, postoperative complications, and longer hospital stay, as it is difficult for surgeons to manage vascular injuries in these deeper areas [68,70,71] .…”

Section: Hand-assisted and Hybrid Donor Hepatectomymentioning

confidence: 99%

The evolution of minimally invasive surgery in liver transplantation for hepatocellular carcinoma

Sioutas¹,

Tsoulfas²

2021

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Hepatocellular carcinoma (HCC) is a malignant neoplasm associated with significant mortality worldwide. The most commonly applied curative options include liver resection and liver transplantation (LT). Advances in technology have led to the broader implementation of minimally invasive approaches for liver surgery, including laparoscopic, hybrid, hand-assisted, and robotic techniques. Laparoscopic liver resection for HCC or living donor hepatectomy in LT for HCC are considered to be feasible and safe. Furthermore, the combination of laparoscopy and LT is a recent impressive and promising achievement that requires further investigation. This review aims to describe the role of minimally invasive surgery techniques utilized in LT for HCC.

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“…The vast majority of donor right hepatectomies has been performed through a right subcostal incision , but such incisions have been associated with a high incidence of scar tightness, sensation issues, and wound complications . In LADH, mobilization of the right liver is performed under laparoscopic guidance, and hepatic hilar dissection and parenchymal transection can be performed through an upper midline or transverse incision with instruments and techniques similar to those used in open donor hepatectomy .…”

Section: Laparoscopy‐assisted Donor Hepatectomymentioning

confidence: 99%

“…This approach does not interrupt the muscle layer and is associated with a lower incidence of abdominal wall discomfort than the open procedure . A recent meta‐analysis found that LADH had advantages over traditional open donor hepatectomy in terms of faster recovery, better cosmetic satisfaction, and less blood loss . Suh et al .…”

Section: Laparoscopy‐assisted Donor Hepatectomymentioning

confidence: 99%

Laparoscopic donor hepatectomy

Chen

Siow

Chio

et al. 2018

Asian J Endoscop Surgery

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Laparoscopic liver resection has been applied to treat most indications for liver resection during the past two decades. According to the literature, patient numbers have increased exponentially as a result, and surgical difficulty has increased as well. In expert centers, laparoscopic anatomical hemihepatectomy and major liver resection more than 3 segments have become the acceptable treatment. Moreover, with surgical innovations and accumulated experience, living donor liver transplantation has become an established treatment choice for patients on the transplant waiting list. It is even considered an inevitable choice in regions with limited access to organs from deceased donors. However, significant morbidity and rare but catastrophic mortality are associated with donor hepatectomy and remain major concerns. Therefore, to decrease the incidence of complications, a minimally invasive approach in donor hepatectomy was adopted in the early 2000s. Initially, a minimally invasive approach was used for left lateral sectionectomy for pediatric liver transplant, then for laparoscopy-assisted hemihepatectomy and pure laparoscopic/robotic right donor hepatectomy, and more recently, for adult living donor liver transplantation. The extent of procedure complexity and potential complications depends on the approach and the size of the graft to be harvested. Early results from expert teams have seemed promising in terms of shortened donor recovery and improved perioperative outcomes. However, the combination of these two highly sophisticated surgical procedures raise more concerns about donor safety, especially with regard to unexpected events during the operation. A high level of evidence is very difficult to achieve in this highly specialized surgical practice with limited penetration. Therefore, an international registry has been suggested to determine the risks and benefits before the use of laparoscopic right donor hepatectomy spreads.

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Laparoscopy-Assisted versus Open Hepatectomy for Live Liver Donor: Systematic Review and Meta-Analysis

Cited by 26 publications

References 22 publications

Minimally invasive donor hepatectomy, are we ready for prime time?

Minimally invasive donor hepatectomy, are we ready for prime time?

The evolution of minimally invasive surgery in liver transplantation for hepatocellular carcinoma

Laparoscopic donor hepatectomy

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