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Jinsoo Rhu, Gyu Seong Choi, Jong Man Kim, Choon Hyuck David Kwon, Jae-Won Joh
(Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea)
Ann Transplant 2019; 24:115-122
The purpose of this study was to investigate the feasibility of using intraoperative ultrasonography as a guidance in dividing bile duct during laparoscopic donor hepatectomy.
MATERIAL AND METHODS: Cases of living liver donors who underwent laparoscopic living donor hepatectomy from May 2013 to December 2017 were reviewed. Operative and postoperative data were compared between donors with intraoperative ultrasonography and donors with intraoperative cholangiography. For analyzing whether bile duct division was performed successfully, anatomical type and number of bile duct openings were reviewed. When the number of bile ducts were achieved as expected, it was considered “successful”.
RESULTS: Intraoperative cholangiography was used in 67 donors (62.6%) while intraoperative ultrasonography was used in 36 donors (33.6%). Mean operation time was 405.0±76.2 minutes versus 275.1±37.5 minutes, P<0.001, respectively, and was longer in donors who had a cholangiography. There was no difference in the success rate of bile duct division between donors who had a cholangiography (92.5%) and donors who had an ultrasonography (88.9%, P=0.716). The mean hospital stay after operation was longer in donors who had a cholangiography (11.6±4.3 days versus 9.0±2.7 days, P<0.001). There was no difference in biliary complication rate between donors who had a cholangiography (11.9%) and donors who had an ultrasonography (8.3%, P=0.743).
CONCLUSIONS: Intraoperative ultrasonography can be used safely in dividing bile duct during laparoscopic living donor hepatectomy with similar outcomes to intraoperative cholangiography.
Keywords: Laparoscopy, Liver Transplantation, Living Donors, Ultrasonography, Doppler, Color