title: Totally laparoscopic living donor right hepatectomy in a donor with trifurcation of bile duct.
abstract: Donor operation in adult living donor liver transplantation is associated with significant postoperative morbidity. To avoid laparotomy wound complications and shorten postoperative recovery, laparoscopic liver graft harvest has been developed recently. However, to determine the cut point of bile duct is challenging. Herein, we report the application of totally laparoscopic approach for right liver graft harvest in a donor with trifurcation of the bile duct. A19-year-old man volunteered for living donation to his father who suffered from hepatitis B virus-related cirrhosis of liver and hepatocellular carcinoma. The graft was 880 mL with a single right hepatic artery and portal vein. The graft to recipient weight ratio was 1.06. The middle hepatic vein was preserved for the donor and the liver remnant was 42.3%. Two branches of middle hepatic veins were > 5 mm in diameter and needed reconstruction with cryopreserved allograft. Ductoplasty using laparoscopic intracorporeal suture technique was done to achieve single orifice of the graft bile duct. The postoperative course was uneventful for the donor. This report adds evidence of the feasibility of pure laparoscopic right donor hepatectomy and describes the necessary steps for bile duct division in donors with trifurcation of bile duct.
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. Electronic address: chen.kuohsin@gmail.com.
authors.forename: Kuo-Hsin
authors.initials: KH
authors.lastname: Chen
authors.affiliation: Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Chun-Chieh
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Tiing-Foong
authors.initials: TF
authors.lastname: Siow
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: U-Chon
authors.initials: UC
authors.lastname: Chio
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Shian-Dian
authors.initials: SD
authors.lastname: Chen
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Ying-Da
authors.initials: YD
authors.lastname: Chen
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Tzu-Chao
authors.initials: TC
authors.lastname: Lin
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Shu-Yi
authors.initials: SY
authors.lastname: Huang
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Jiann-Ming
authors.initials: JM
authors.lastname: Wu
authors.affiliation: Division of General Surgery, Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
authors.forename: Kuo-Shyang
authors.initials: KS
authors.lastname: Jeng
mesh_terms: D001652:Bile Ducts / Q000473:pathology*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D020858:Tissue and Organ Harvesting / Q000379:methods*; D055815:Young Adult
keywords: donor hepatectomy; laparoscopic hepatectomy; living donor liver transplantation; trifurcation of bile duct