Optimal bile duct division using real‐time indocyanine green near‐infrared fluorescence cholangiography during laparoscopic donor hepatectomy

Hong, Suk Kyun; Lee, Kwang‐Woong; Kim, Hyo-Sin; Yoon, Kyung Chul; Ahn, Sung Woo; Choi, Jin Yong; Kim, Hye Young; Yi, Nam‐Joon; Suh, Kyung‐Suk

doi:10.1002/lt.24686

Cited by 56 publications

(49 citation statements)

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“…Since the initiation of PLDH using the left lateral section in 2001, the recommended procedure is pure laparoscopic donor left lateral sectionectomy because of its similar safety results to open surgery and the advantages of minimally invasive surgery . With the accumulation of experience and the continuing development of surgical instruments and techniques, PLDRH is increasingly performed in experienced centers . However, there are still little data available for a full left liver graft including the MHV.…”

Section: Discussionmentioning

confidence: 99%

“…The PLDLH technique is based on the liver hanging maneuver, the demarcation of the exact midplane of the liver using indocyanine green (ICG) near‐infrared fluorescence, and the optimal bile duct division using real‐time ICG near‐infrared fluorescence cholangiography, which is similar to the PLDRH technique (Fig. ) . The PLDRH technique used at our center has been described in detail elsewhere .…”

Section: Methodsmentioning

confidence: 99%

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Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

et al. 2020

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Pure laparoscopic donor hepatectomy (PLDH) has become increasingly accepted in the era of minimally invasive surgeries. However, the outcomes of pure laparoscopic donor left hepatectomy (PLDLH) are relatively less known than for left lateral sectionectomy or right hepatectomy. This study aimed to report our experience with and the outcomes of PLDLH including the middle hepatic vein (MHV) and to compare these outcomes with conventional donor left hepatectomy (CDLH). The medical records of living liver donors between January 2010 and January 2018 at Seoul National University Hospital were retrospectively reviewed. Donors who underwent left hepatectomy including the MHV were included. To minimize selection bias, donors who underwent CDLH after the initiation of the PLDH program were excluded. Finally, there were 18 donors who underwent CDLH and 8 who underwent PLDLH. The median (interquartile range [IQR]) warm ischemia time (11 [10‐16] minutes versus 4 [2‐7] minutes; P = 0.001) was longer in the PLDLH group than the CDLH group. The total operation time (333 [281‐376] minutes versus 265 [255‐308] minutes; P = 0.09) and time to remove the liver (245 [196‐276] minutes versus 182 [172‐205] minutes; P = 0.08) were also longer in PLDLH although not statistically significant. The length of postoperative hospital stay was significantly shorter in the PLDLH group (7 [7‐8] days versus 9 [8‐10] days; P = 0.01). There were no postoperative complications in the PLDLH group. The rate of complications in recipients was similar in both groups. In conclusion, PLDLH including the MHV appears to be safe and feasible. Further analysis including longterm outcomes is needed.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

et al. 2020

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“…with 25, 18, and 15 years of experience in liver transplantation and hepatectomy, respectively) in the same institute. During operation, real‐time fluorescent cholangiography was obtained 30∼60 minutes after intravenous injection of indocyanine green (0.05 mg/kg) with either the Pinpoint (Novadaq, Ontario, Canada) or LuxEndoBright (Korea Electrotechnology Research Institute, Seoul, Korea) . After comparing the results of the real‐time fluorescent cholangiography with preoperative MRC imaging results, when the right or left hepatic duct, and the caudate or aberrant bile duct, were clearly visualized, the appropriate cutting lines of the bile ducts for donor were determined by the surgeons.…”

Section: Methodsmentioning

confidence: 99%

“…During operation, real-time fluorescent cholangiography was obtained 3060 minutes after intravenous injection of indocyanine green (0.05 mg/kg) with either the Pinpoint (Novadaq, Ontario, Canada) or LuxEndoBright (Korea Electrotechnology Research Institute, Seoul, Korea). 22 After comparing the results of the realtime fluorescent cholangiography with preoperative MRC imaging results, when the right or left hepatic duct, and the caudate or aberrant bile duct, were clearly visualized, the appropriate cutting lines of the bile ducts for donor were determined by the surgeons. They recorded the hilar branching anatomy of BD, the number of BD openings along the surgical resection plane of right hemihepatectomy, and the number of BD anastomoses in consensus.…”

Section: Intraoperative Correlationmentioning

confidence: 99%

Additional values of high‐resolution gadoxetic acid‐enhanced MR cholangiography for evaluating the biliary anatomy of living liver donors: Comparison with T₂‐weighted MR cholangiography and conventional gadoxetic acid‐enhanced MR cholangiography

Kang

Lee

Yoon

et al. 2017

Magnetic Resonance Imaging

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Purpose: To determine the incremental value of small field of view (sFOV) high-resolution (HR) gadoxetic acid-enhanced 3D T 1 -weighted (W) magnetic resonance cholangiography (MRC) for evaluating the biliary anatomy of potential living donors by comparing it to T 2 W-MRC. Materials and Methods: In all, 73 living donor candidates underwent gadoxetic acid-enhanced MRI (3.0T) including three kinds of MRCs: 3D multislice T 2 W-MRC, regular FOV (rFOV) (380 3 380mm, resolution 1.0 3 1.2 3 3.0 mm) 3D T 1 W-MRC, and sFOV (256 3 208 mm, resolution 1.0 3 1.0 3 1.0 mm) HR-T 1 W-MRC. Three radiologists reviewed the image sets for the visibility of segmental intrahepatic bile ducts (BDs), biliary anatomy with its confidence level, and expected number of BD openings at right hemihepatectomy. Results: Compared to T 2 W-MRC alone, the combination of sFOV HR-T 1 W-MRC and T 2 W-MRC (sT 1 W-HR set) yielded significantly improved BD visibility scores (P < 0.01) and confidence levels for biliary anatomy (P < 0.01). Compared to the rT 1 W set (rFOV T 1 W-MRC with T 2 W MRC), the sFOV HR set showed significantly increased caudate duct visibility (P < 0.001). In the case of T 2 W-MRC presenting subdiagnostic image quality, the addition of sFOV HRT 1 W-MRC provided diagnostically acceptable image visibility (53.890%) to all reviewers. The addition of sFOV HR-T 1 W-MRC resulted in a significantly higher consistency with the operative record and expected number of BD openings than did T 2 W-MRC alone (P < 0.05 in all reviewers) or rFOV set (P < 0.05 in one reviewer) with excellent interobserver agreement of both T 1 W-MRC sets. Conclusion: The combination of sFOV HR-T 1 W-MRC and T 2 W-MRC significantly improved BD visibility and confidence levels for biliary anatomy compared to T 2 W-MRC alone, thereby allowing accurate biliary anatomy assessment in most patients with subdiagnostic T 2 W-MRC images. Level of Evidence: 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2018;47:152-159.

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“…2). (12) At this point, RHD variations should be considered. The association with double RHDs is commonly seen.…”

Section: Hepatic Parenchymal Transectionmentioning

confidence: 99%

Pure Laparoscopic Living Donor Hepatectomy for Donors With Right Portal Vein Anatomical Variations

Shehta

Lee

et al. 2019

Liver Transpl

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Optimal bile duct division using real‐time indocyanine green near‐infrared fluorescence cholangiography during laparoscopic donor hepatectomy

Cited by 56 publications

References 5 publications

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

Additional values of high‐resolution gadoxetic acid‐enhanced MR cholangiography for evaluating the biliary anatomy of living liver donors: Comparison with T₂‐weighted MR cholangiography and conventional gadoxetic acid‐enhanced MR cholangiography

Pure Laparoscopic Living Donor Hepatectomy for Donors With Right Portal Vein Anatomical Variations

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Optimal bile duct division using real‐time indocyanine green near‐infrared fluorescence cholangiography during laparoscopic donor hepatectomy

Cited by 56 publications

References 5 publications

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

Additional values of high‐resolution gadoxetic acid‐enhanced MR cholangiography for evaluating the biliary anatomy of living liver donors: Comparison with T2‐weighted MR cholangiography and conventional gadoxetic acid‐enhanced MR cholangiography

Pure Laparoscopic Living Donor Hepatectomy for Donors With Right Portal Vein Anatomical Variations

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Additional values of high‐resolution gadoxetic acid‐enhanced MR cholangiography for evaluating the biliary anatomy of living liver donors: Comparison with T₂‐weighted MR cholangiography and conventional gadoxetic acid‐enhanced MR cholangiography