Technical refinement preserving segment 4 to donor in extended right hepatectomy
Suh, K-Suk.; Yi, N-Joon.; Cho, J.Yong.; Kwon, C.Hyuck.; Minn, K.Won.; Lee, K.Uk.
Hepato-Gastroenterology 53(68): 253-257
2006
ISSN/ISBN: 0172-6390 PMID: 16608034 Document Number: 603047
Background/Aims: Donor extended right hepatectomy, including the middle hepatic vein (MHV) and a part of segment 4 (Sg4), is performed to overcome inadequate graft for large adult recipient as resolving congestion of right anterior section. However, using this technique remnant donor liver is often too small. Here, we introduce a technical modified extended right hepatectomy (MERH), in which the MHV was excavated preserving the entire Sg4 in the donor.Methodology: We compared clinical outcomes between donors using our technique (n=12) that may result in Sg4 congestion, and right hepatectomy (RH, n=12) that may not. MERH was performed when the remnant donor liver had a volume exceeding 35% and showed no steatosis in preoperative imaging study.Results: No donor died, and there were no differences in operative time and postoperative recovery between the two groups (p > 0.05). The regeneration of the remnant liver after MERH and RH were similar (160.2% us. 187.7% at POD 10; 222.2% vs. 230.5% at 4 months) (p > 0.05).Conclusions: Our results show that MERH didn't impair recovery or liver regeneration in donors, and indicate that MERH will be useful in adult living donor liver transplantation.