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单纯腹腔镜活体供体右半肝切除术的安全性和可行性

Safety and feasibility of pure laparoscopic living donor right hepatectomy.

作者信息

Kim Sang-Hoon, Kim Ki-Hun, Rotellar Fernando, Aliseda Daniel

机构信息

Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.

HPB and Liver Transplant Unit, Department of General Surgery, Clinica Universidad de Navarra, University of Navarra, Pamplona, Spain.

出版信息

Updates Surg. 2024 Oct 15. doi: 10.1007/s13304-024-01920-5.

Abstract

Pure laparoscopic living-donor right hepatectomy (PLDRH) has emerged as a significant advancement in liver transplantation, offering reduced donor morbidity and improved recovery times. However, PLDRH is still performed in only a limited number of centers. This retrospective study reports on the outcomes of 215 living donors who underwent PLDRH at Asan Medical Center in Seoul, Korea between November 2014 and December 2021. We reviewed donor and recipient demographics and anatomical characteristics of the donor grafts. Donor complications were classified and evaluated based on the Clavien-Dindo classification. The incidence of early donor complications within 30 days of surgery was 0.9% (n = 3), with minor complications in 0.3% (n = 1) patients and major complications in 0.6% (n = 2). No biliary complications were observed and no late complications had been reported by 30 days after surgery. The mean length of postoperative hospital stay was 7.2 days. PLDRH was a safe and feasible surgical technique characterized by a low complication rate and short hospital stays. PLDRH has the potential to become the standard procedure for the retrieval of right liver grafts from living donors.

摘要

纯腹腔镜活体供体右半肝切除术(PLDRH)已成为肝移植领域的一项重大进展,可降低供体发病率并缩短恢复时间。然而,实施PLDRH的中心数量仍然有限。这项回顾性研究报告了2014年11月至2021年12月期间在韩国首尔峨山医学中心接受PLDRH的215名活体供体的手术结果。我们回顾了供体和受体的人口统计学数据以及供体移植物的解剖特征。根据Clavien-Dindo分类法对供体并发症进行分类和评估。术后30天内早期供体并发症的发生率为0.9%(n = 3),其中轻微并发症发生率为0.3%(n = 1),严重并发症发生率为0.6%(n = 2)。未观察到胆系并发症,术后30天内也未报告晚期并发症。术后平均住院时间为7.2天。PLDRH是一种安全可行的手术技术,具有并发症发生率低和住院时间短的特点。PLDRH有可能成为从活体供体获取右肝移植物的标准术式。

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