Suh Kyung-Suk, Kim Seong Hoon, Kim Sang Beom, Lee Hyuk-Joon, Lee Kuhn Uk
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Liver Transpl. 2002 Oct;8(10):910-5. doi: 10.1053/jlts.2002.35665.
The goal of this study was to examine the safety and effectiveness of right lobectomy in living donor liver transplantation (LDLT). From January 1999 to January 2002, 100 cases of LDLT were performed at Seoul National University Hospital; 45 involved right lobectomy (RL), 17 involved extended left lobectomy (ELL), 37 involved left lateral segmentectomy (LLS), and 1 involved right posterior segmentectomy. The outcome of RL was compared with those of other types of hepatectomy. An RL resulted in a longer operative time (minutes) than an LLS (349.0 +/- 65.1 versus 286.7 +/- 54.0, P < .01), but not an ELL (351.2 +/- 84.3, P = .99). The hospital stay (days) in the RL group (14.4 +/- 3.1) was longer than for those in the ELL group (11.7 +/- 1.7, P < .01) and the LLS group (11.7 +/- 1.9, P < .01). The drain amount (mL) of the postoperative third day in the RL group (194.4 +/- 143.4) was larger than for those in the ELL group (56.8 +/- 84.1, P < .01) and the LLS group (46.5 +/- 39.6, P < .01). The postoperative peak serum level of total bilirubin (mg/dL) was 3.0 +/- 1.5 in the RL group, 1.9 +/- 0.7 in the ELL group, and 1.9 +/- 0.9 in the LLS group (P < .01, RL versus LLS, ELL). There was no mortality or major morbidity and no reoperation of donors. Right lobectomy is a relatively safe and effective procedure in LDLT, but brings more potential risks and morbidity in donors.
本研究的目的是探讨活体肝移植（LDLT）中右半肝切除术的安全性和有效性。1999年1月至2002年1月，首尔国立大学医院共进行了100例LDLT；其中45例为右半肝切除术（RL），17例为扩大左半肝切除术（ELL），37例为左外叶切除术（LLS），1例为右后叶切除术。将RL的结果与其他类型肝切除术的结果进行比较。与LLS相比，RL的手术时间（分钟）更长（349.0±65.1对286.7±54.0，P<.01），但与ELL相比无差异（351.2±84.3，P=.99）。RL组的住院时间（天）（14.4±3.1）比ELL组（11.7±1.7，P<.01）和LLS组（11.7±1.9，P<.01）更长。RL组术后第三天的引流量（mL）（194.4±143.4）比ELL组（56.8±84.1，P<.01）和LLS组（46.5±39.6，P<.01）更多。RL组术后血清总胆红素峰值（mg/dL）为3.0±1.5，ELL组为1.9±0.7，LLS组为1.9±0.9（P<.01，RL与LLS、ELL相比）。供体无死亡或严重并发症，也无需再次手术。右半肝切除术在LDLT中是一种相对安全有效的手术，但会给供体带来更多潜在风险和并发症。
