Right hepatectomy in living donors with previous abdominal surgery

作     者：Seong Hoon Kim Seung Duk Lee Young Kyu Kim Sang-Jae Park 

作者机构：Center for Liver Cancer National Cancer Center 111 Jungbalsan-ro Ilsandong-gu Goyang-si Gyeonggi-do 410-769 Korea 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2017年第16卷第1期

页      面：33-38页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：living donor liver transplantation liver surgery liver function 

摘      要：BACKGROUND： Few studies have evaluated the impact of previous abdominal surgery （PAS） on living donor right hepatectomy （LDRH）. The aim of this study was to investigate the outcomes of liver transplantation using right lobe grafts of living donors with PAS. METHODS： Data were reviewed from LDRH patients at the authors＇ institution between March 2008 and November 2014. LDRH patients with PAS were divided into two groups according to upper PAS （group 1） or lower PAS （group 2）, and they were compared to those without PAS （group 3） who were matched 1：1 based on age, gender, and body mass index. Periop- erative data, complications by the Clavien classification, and the outcomes with more than 14 months follow-up were compared. RESULTS： Twenty-three （4.9%） of a total of 471 LDRH donors had PAS. Eleven donors were assigned to group 1, 12 to group 2, and 23 to group 3. Intraperitoneal adhesions were found in 20 （87.0%） of 23 donors with PAS, of whom 5 （21.7%） had adhesiolysis-related injuries that happened more commonly in group 1 than in group 2 （P=0.025）. LDRH was successfully completed under upper midline laparotomy in all donors. No donors received perioperative blood transfusion. The peak postoperative AST, ALT, INR, and total bilirubin levels made no difference between the three groups. Compared with group 3, groups 1 and 2 had a longer operative time （P=0.012） and a higher grade I complication rate （P=0.047）. All donors recovered fully to their routine activities. The 23 recipients of grafts from donors with PAS showed good liver function with 1-year graft and patient survivals of 100%. CONCLUSION： A history of PAS is not a contraindication to LDRH in the current era of advanced surgical techniques.