Pure Laparoscopic versus Open Right Hepatectomy in Live Liver Donors: A Propensity Score Matched Analysis

Abstract

Background: Although PLDRH is gradually spreading worldwide, their outcomes including long-term outcomes of both donor and recipient have not yet been evaluated in a large comparative study. The aim of this study is to present the safety and feasibility of pure laparoscopic donor right hepatectomy (PLDRH) compared with that of conventional donor right hepatectomy (CDRH). Methods: We retrospectively reviewed the medical records of 894 donors who underwent LDLT between January 2010 to September 2018 at Seoul National University Hospital were reviewed. We performed 1:1 propensity score matching between the PLDRH and CDRH groups. Subsequently, 198 donor and counter recipients were included in each group. Results: The total operation time (P< 0.001), time to remove the liver (P< 0.001), and warm ischemic time (P< 0.001) were longer in the PLDRH group. The length of postoperative hospital stay was significantly shorter in the PLDRH group (P< 0.001). Although the rate of complication in donor was similar between the two groups, the rates of early (P=0.019) and late (P< 0.001) biliary complication in recipient were higher in PLDRH group. There was no significant difference in overall survival and graft survival between the two groups. Conclusion: PLDRH is feasible when performed at an experienced LDLT center. Further studies on long-term recipient outcomes including biliary complications are needed to confirm the safety.