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Upper Midline Incision Could Become Standard Practice for Living Donor Right Hepatectomy
1Division of Hepatobiliary Pancreas Surgery and Liver Transplantation, Department of Surgery, Catholic University of Daegu College of Medicine, Daegu, Korea.
Transplantation Proceedings
|January 26, 2022
Summary
Living right donor hepatectomy (LDRH) using a small upper midline incision (UMI) is safe and effective. This approach reduces hospital stay and operation time compared to traditional J-shaped incisions, supporting its use as standard practice.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Organ Transplantation
Background:
- Laparoscopic living right donor hepatectomy (LDRH) is challenging due to technical demands and donor morbidity.
- Upper midline incision (UMI) has been explored to reduce donor morbidity in LDRH.
- This study evaluates the safety and efficacy of a small UMI for LDRH.
Purpose of the Study:
- To compare outcomes of LDRH using a small upper midline incision (UMI) versus a J-shaped incision.
- To assess the feasibility and safety of UMI as a standard approach for LDRH.
Main Methods:
- Retrospective review of 444 LDRH cases (2010-2019).
- Comparison of 124 donors in the UMI group with 320 donors in the J-shaped incision group.
- Analysis of demographic data, intraoperative parameters, laboratory results, and postoperative complications.
Main Results:
- No significant difference in overall complication rates between UMI and J-shaped groups.
- UMI group showed significantly shorter hospital stays and operation times.
- Large grafts (>900 g) and hepatic steatosis (≥15%) were risk factors for difficult operations, independent of incision type.
Conclusions:
- Small UMI is a safe and viable option for LDRH.
- This approach can be considered for standard practice in LDRH.
- UMI offers advantages in reduced patient recovery time and surgical duration.
