title: Laparoscopy-assisted hybrid left-side donor hepatectomy.
abstract: BACKGROUND
  Laparoscopic liver resection developed for live liver donors has the advantage of reducing the physical and mental stress in donors. However, its safety and efficacy still remain to be established. We aimed to evaluate the feasibility, safety and efficacy of laparoscopy-assisted hybrid donor hepatectomy (LADH) to obtain left side grafts.
  
  
  METHODS
  A total of 31 consecutive live liver donors of left side liver grafts underwent LADH, including left lateral segmentectomy (n = 17) and left liver resection with or without the caudate lobe (n = 14) (LADH group). We compared the clinical data between the LADH group and the group of donors in whom traditional open donor hepatectomy was performed to procure the liver graft (open donor hepatectomy [ODH] group, n = 79).
  
  
  RESULTS
  Laparoscopy-assisted hybrid donor hepatectomy was feasible in all patients, and there was no mortality over a follow-up period of 13.9 ± 9.8 months. The operative time to procure a left-lobe graft was significantly longer in the LADH group (510 ± 90 min) than in the ODH group (P < 0.001). A large right lobe on CT (RPv distance) was identified as a significant risk factor for prolonged operative time (P = 0.007). Evaluation using the SF36-v2 questionnaire revealed faster recovery of the physical component summary score and bodily pain score in the LADH group than in the ODH group.
  
  
  CONCLUSIONS
  Laparoscopy-assisted hybrid donor hepatectomy for procuring left side grafts was safe and effective up to the left liver with the caudate lobe. Left-lobe LADH in donors with a large right lobe should be carefully planned in view of the potential surgical difficulty.
authors.affiliation: Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. smarubashi@gesurg.med.osaka-u.ac.jp
authors.forename: Shigeru
authors.initials: S
authors.lastname: Marubashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Wada
authors.forename: Koichi
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Shogo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Eguchi
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagano
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005240:Feasibility Studies; D005260:Female; D006305:Health Status Indicators; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011788:Quality of Life; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed; D055815:Young Adult