Pure laparoscopic versus open left lateral hepatectomy in pediatric living donor liver transplantation: a review and meta-analysis

Abstract

Purpose: The meta-analysis was conducted to evaluate the safety and feasibility of pure laparoscopic left lateral hepatectomy in comparison with open approach for pediatric living donor liver transplantation (LDLT).Methods: A systemic literature survey was performed by searching the PubMed, EMBASE and Cochrane Library databases for articles that compared pure laparoscopic left lateral living donor hepatectomy (LLDH) and open left lateral living donor hepatectomy (OLDH) by November 2021. Meta-analysis was performed to assess donors' and recipients' perioperative outcomes using RevMan 5.3 software.Results: A total of seven studies involving 489 patients were included in the analysis. The results demonstrated that LLDH group had signi cantly less blood loss (WMD=-82.12ml, 95%CI: -109.56-54.67, P<0.00001) and shorter length of hospital stay (WMD=-2.36d, 95%CI: -3.19--1.52, P<0.00001) compared with OLDH group. A reduced overall postoperative complication rate was observed in the LLDH group (OR=0.32, 95%CI: 0.15-0.68, P=0.003). In the subgroup analysis, donor bile leakage, wound infection and pulmonary complications were similar between two groups (bile leakage: OR=1.