Introduction: Pure laparoscopic donor hepatectomy (PLDH) is increasingly becoming the standard for donor surgery. However, pure laparoscopic donor left hepatectomy (PLDLH) is not yet more widely performed than pure laparoscopic donor right hepatectomy (PLDRH). This study is performed to evaluate safety and feasibility of PLDLH.
Method: From March 2019 to September 2023, PLDH was performed on 124 patients at our center. Among them, 11 patients underwent PLDLH for extended left lobe (ELL) graft without caudate, and 113 patients underwent PLDRH for modified right lobe (MRL) graft. In these two groups, donor safety was first compared, and then, the recipient outcomes were compared according to the type of graft. The medical records of PLDH at Seoul St. Mary’s Hospital were retrospectively reviewed.
Results: The PLDLH group had 10 men (90.9%), which was higher than the PLDRH (48.5%) group. There was no difference in preoperative BMI, liver function test, bile duct and portal vein variation between the two groups. The operation time was longer in the PLDLH group, but there was no difference in ischemic time. There was no difference in complications of Clavien-Dindo III or higher, such as bile leak. However, the peak level of total bilirubin and PT INR after surgery was lower in the PLDLH group, and the total bilirubin level on the postoperative day 5 was also lower in the PLDLH group.
Conclusions: In the laparoscopic era, PLDLH can be performed as safely as PLDRH and has advantages in terms of donor safety.