Achieving unconscious competence: pure laparoscopic donor hepatectomy at a large volume LDLT centre in India

Abstract

Presenter: Ashish Singhal MBBS, DNB | Fortis Hospitals Background: Pure laparoscopic donor hepatectomy (PLDH) has become accepted surgical procedure in living donor liver transplantation (LDLT). This study aimed to report our initial experience and outcomes of PLDH and to compare the donor and recipient outcomes with conventional open donor hepatectomy (ODH). Methods: The medical records of 147 consecutive (10/ 2019 - 12/2020) LDLTs at our center were retrospectively reviewed. PLDH (n = 65) and ODH (n = 82) groups were compared. Results: There was no difference in baseline characteristics of donor and recipient between the two groups except for patients with higher mean MELD score in PLDH group. The warm ischemia time was significantly higher in PLDH group reflecting as significantly high mean peak transaminases in recipients. The median total operative time (4.3 vs. 7.3 hrs; P < 0.05) and time to retrieve the liver (4.7 hrs vs. 6.2 hrs; P < 0.05) were significantly higher in PLDH. The median time to ambulation and length of postoperative hospital stay was shorter in the PLDH group. There was no difference in postoperative complications among donors or recipients in both groups. Conclusion: PLDH is feasible and can be performed safely as ODH at an experienced LDLT center. Further analysis including long-term outcomes is required.