Donor Hepatectomy for Living Donor Liver Transplantation: Learning Steps and Surgical Outcome
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Shigeru Marubashi Hiroaki Nagano Hiroshi Wada Shogo Kobayashi Hidetoshi Eguchi Yutaka Takeda Masahiro Tanemura Yuichiro Doki Masaki
- چاپ و سال / کشور: 2011
Description
Background and Aim Complications associated with live liver donor surgery should be minimized. There is little information on the impact of team experience and learning on the surgical outcome. The aim of this study was to clarify the impact of team experience in a single center on the outcome of live donor hepatectomy. Methods Graft livers consisted of 56 right lobes, 40 left lobes with/without caudate, 36 left lateral section (LLS), and 11 right posterior section (RPS). Surgeries were divided according to the time of execution: era I (n = 50), era II (n = 50) and era III (n = 43). Results No postoperative mortality was recorded. Blood loss steadily decreased and operation time decreased after era II (P\0.0001). The overall frequency of postoperative morbidities by the Clavien system was significantly less for LLS graft [P = 0.009, right lobe (42.9%) vs. LLS (13.9%)]. Multivariate risk factor analysis showed that donors in recent years were at low risk of morbidity and bile leakage (P = 0.025 and 0.010, respectively). There was less impact for team experience on the outcome in LLS graft than other types of grafts. Conclusion Our analysis demonstrated several learning steps in live liver donor surgery and confirmed their positive impact on surgical outcome.
Dig Dis Sci (2011) 56:2482–2490 DOI 10.1007/s10620-011-1622-1 Received: 8 December 2010 / Accepted: 6 February 2011 / Published online: 22 February 2011
