title: [Clinical application of precise liver surgery techniques for donor hepatectomy in living donor liver transplantation].
abstract: OBJECTIVE
  To evaluate the effect of techniques of precise liver surgery for donor hepatectomy in living donor liver transplantation.
  
  
  METHODS
  Eighty-nine donors aged from 19 to 57 years were performed by the same surgical team from June 2006 to December 2013 in Chinese People's Liberation Army General Hospital.Individualized surgical program were developed according to preoperative imaging examination and hepatic functional reserve examination. The evaluation included liver function, liver volume, vascular anatomy and bile duct anatomy. According to the results after the operation, preoperative evaluation accuracy, postoperative donor liver function and postoperative complications were analyzed. ANOVA analysis was used to compare the difference of graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight. Pearson correlation test and linear regression analysis were used to verify the correlation between the estimated graft volume each method and actual graft postoperative weight.
  
  
  RESULTS
  All the 89 cases operation protocol as following, there were 5 cases with left lateral lobe graft, 10 cases with left lobe liver graft, 74 cases with right lobe graft. There were 59 cases with middle hepatic vein (MHV) harvested, and 30 cases without MHV. The mean graft volume by two-dimensional, three-dimensional calculation method and actual postoperative graft weight were (656.2±134.1) ml, (631.7±143.2) ml and (614.5±137.7) ml respectively. ANOVA analysis results showed that there were no statistically significant difference in the three methods (P>0.05). Compared to the actual postoperative graft weight, the average error rate of the two methods were 7.9% and 5.3% respectively. Pearson correlation test showed the graft volume calculated by two-dimensional and three-dimensional methods had a significantly positive correlation with actual graft weight (r=0.821, 0.890, P<0.01) and linear regression analyze showed the R2 were 0.674 and 0.792, respectively. The accuracy rate of preoperative evaluation about portal vein, hepatic vein, hepatic artery and bile duct were 100%, 100%, 97.8% and 95.5%, respectively. The preoperative plan and postoperative practical scheme coincidence rate was 95.5%. Overall donor complication rate was 7.4%. All donors were alive. Sixteen donors received right lobe hepatectomy with gallbladder preserved had a good liver function and gallbladder function.
  
  
  CONCLUSIONS
  Through the precise preoperative evaluation, surgical planning, fine operation and excellent postoperative management, precise liver surgery technique can ensure the safety of donor in living donor liver transplantation.
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Yanhua
authors.initials: Y
authors.lastname: Lai
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China; Email: dongjh301@163.com.
authors.forename: Jiahong
authors.initials: J
authors.lastname: Dong
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Weidong
authors.initials: W
authors.lastname: Duan
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Ye
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Wenbin
authors.initials: W
authors.lastname: Ji
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Leng
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Luo
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Xiangfei
authors.initials: X
authors.lastname: Meng
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Dongxin
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Shi
authors.affiliation: Institute of Hepatobiliary Surgery, Hospital of Hepatobiliary Surgery, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Huang
mesh_terms: D000328:Adult; D001652:Bile Ducts; D001835:Body Weight; D006498:Hepatectomy / Q000379:methods*; D006499:Hepatic Artery; D006503:Hepatic Veins; D006801:Humans; D016014:Linear Models; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008875:Middle Aged; D011169:Portal Vein; D011183:Postoperative Complications; D011184:Postoperative Period; D055815:Young Adult