Surgical results of left lobectomy and left hepatectomy in 70 noncirrhotic patients. A preliminary evaluation before performing liver transplantation from living related donors.
As a preliminary step before performing liver transplantation using living related donors, a comparative study was undertaken to determine the specific operative risk of left lobectomy (n = 54) compared to left hepatectomy (n = 16) in noncirrhotic patients. No postoperative death was observed in either group and no patients required reoperation. The mean hospital stay was longer after left hepatectomy than after left lobectomy (23 +/- 15 days vs 10 +/- 3 days, P < 0.05). The postoperative course was uneventful in 94% of the patients after left lobectomy and in 44% after left hepatectomy (P < 0.001). The peroperative transfusion rate was higher after left hepatectomy than after left lobectomy (38% vs 4%, P = 0.001). The postoperative collection rate was higher after left hepatectomy than after left lobectomy (25% vs 6%, NS). No biliary fistulas or subphrenic abscesses were noted after left lobectomy; however, these were observed in 19% and 12% of the cases, respectively, after left hepatectomy. Although conventional liver resection is quite different from graft harvesting in living related transplantation, our study demonstrates that the morbidity rate is significantly higher after left hepatectomy than after left lobectomy.
Panis
Y
Y
Service de Chirurgie Digestive, Université Paris VII, Hôpital Beaujon, Clichy, France.
Penna
C
C
Sauvanet
A
A
Belghiti
J
J
D000328:Adult; D000368:Aged; D005069:Evaluation Studies as Topic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000601:surgery*; D008107:Liver Diseases / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D014019:Tissue Donors