Early experience with pure laparoscopic donor hepatectomy: comparison with open donor hepatectomy and non‐donor laparoscopic hepatectomy

Abstract

AbstractBackgroundPure laparoscopic donor hepatectomy (L‐DH) has seen a rise in uptake in recent years following the popularization of minimally invasive modality for major hepatobiliary surgery. Our study aimed to determine the safety and compare the perioperative outcomes of L‐DH with open donor hepatectomy (O‐DH) and laparoscopic non donor hepatectomy (L‐NDH) based on our single institution experience.MethodsEighty of 113 laparoscopic hemi‐hepatectomies performed between 2015 and 2022 met study inclusion criteria. Of these, 11 were L‐DH. PSM in a 1:2 ratio of L‐DH versus L‐NDH and 1:1 ratio of L‐DH versus O‐DH were performed, identifying patients with similar baseline clinicopathological characteristics.ResultsAfter 2:1 matching, the L‐DH cohort were significantly younger (P < 0.001) and had lower ASA scores (P < 0.001) than the L‐NDH cohort. L‐DH was associated with a longer median operating time (P < 0.001) and shorter median postoperative stay (P < 0.001) than L‐NDH. After 1:1 matching, there were no significant differences in baseline demographic between the L‐DH and O‐DH cohorts. L‐DH was associated with lower median blood loss (P = 0.040) and shorter length of stay compared to O‐DH (P = 0.004). There were no significant differences in recipient outcomes for both cohorts.ConclusionL‐DH can be adopted safely by surgeons experienced in L‐NDH and ODH. It is associated with decreased blood loss and shorter length of stay compared to O‐DH.