Zhang Hai-Ming, Wei Lin, Li Hong-Yu, Sun Li-Ying, Qu Wei, Zeng Zhi-Gui, Liu Ying, Zhu Zhi-Jun
Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Clinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, China.
Hepatobiliary Surg Nutr. 2023 Jun 1;12(3):328-340. doi: 10.21037/hbsn-21-418. Epub 2022 Jul 7.
Although laparoscopic living donor left lateral section liver procurements represents an established and safe procedure, there remains much discussion on this topic. In particular, the issue of whether laparoscopic living donor liver procurement increases the difficulty of the surgery and potential complications for recipients continue to confound experts in this field.
In this report, data from 180 cases of living donor left lateral section liver transplantation patients were analyzed retrospectively. Of these 180 cases, 106 grafts were procured by open surgery and 74 by pure laparoscopic surgery.
While surgery durations and blood loss were decreased in donors from the laparoscopic surgery group, increased biliary openings of grafts and relatively high peak aspartate aminotransferase (AST) levels were present in both donors and recipients with this procedure.
Laparoscopic living donor left lateral section liver procurement represents a safe and effective procedure for both donors and recipients. However, laparoscopic surgery can more frequently lead to multiple biliary tracts in the graft and its impact on the prognosis of recipients remains uncertain. Use of routine X-ray based intraoperative cholangiography may help to reduce this problem.
尽管腹腔镜活体供体左外叶肝获取术是一种成熟且安全的手术,但关于该主题仍存在诸多讨论。特别是,腹腔镜活体供肝获取术是否会增加手术难度以及给受者带来潜在并发症这一问题,仍然困扰着该领域的专家。
在本报告中,对180例活体供体左外叶肝移植患者的数据进行了回顾性分析。在这180例病例中,106例移植物通过开放手术获取,74例通过单纯腹腔镜手术获取。
虽然腹腔镜手术组供体的手术时间和失血量有所减少,但采用该手术的供体和受者均出现移植物胆管开口增加以及相对较高的天冬氨酸转氨酶(AST)峰值水平。
腹腔镜活体供体左外叶肝获取术对供体和受者而言都是一种安全有效的手术。然而,腹腔镜手术更常导致移植物出现多条胆管,其对受者预后的影响仍不确定。使用基于术中X线的常规胆管造影术可能有助于减少这一问题。