부산대학교 도서관

Aims: Laparoscopic major hepatectomy is still innovative, and also laparoscopic donor hepatectomy is conducted in only several centers. In this study, we propose highly strict selection criteria for laparoscopic donor hepatectomy to reduce surgical complications. Methods: From May, 2013 to Jan. 2017, we conducted 72 cases’ consecutive laparoscopic living donor hepatectomy. After early trial and error, we had a strict indication on donor’s selection- normal anatomy (type 1 bile dcut, type 1. Portal vein). But in some cases, biliary complications were shown despite strict selection. And so We reviewed all donor’s biliary anatomy and classified by length of neck of right bile dcut(1cm). In this study, 64 donor’s enrolled after laparoscopic donation of right liver. And We classified by the length of right bile duct(from bifurcation of right/left bile duct to bifurcation of anterior/posterior bile duct) In group 1 with the length of right bile duct is over 1cm, 42 donors enrolled and group 2 was consisted with 22 donors (short length of right bile duct<1cm). Results: By statistical analysis, group1 showed only 1 donor’s biliary leakage from cystic duct( 2%) but this complication was controlled by laparoscopic exploration. In contrast to previous, group 2 has showed 6 donor’s biliary leakage and 1 donor’s biliary stricture. (32%) one donor's complication was successfully controlled by laparoscopic suture of leaked bile duct, and other complicated donors were managed with endoscopic retrograde biliary drainage procedure without any long-term complications. Conclusions: In laparoscopic donor hepatectomy, highly strict selection by donor’s biliary anatomy,- type1 bile duct plus length of right bile duct over 1cm- will help to reduce donor’s biliary complications.