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Surgical Endoscopy

, Volume 29, Issue 11, pp 3047–3064 | Cite as

Donor safety in live donor laparoscopic liver procurement: systematic review and meta-analysis

  • Mohamed BekheitEmail author
  • Philipe-Abrahim Khafagy
  • Petru Bucur
  • Khaled Katri
  • Ahmed Elgendi
  • Wael Nabil Abdel-salam
  • Eric Vibert
  • El-said El-kayal
Review

Abstract

Background

Donor safety is a major concern in live organ donation. Live donor laparoscopic liver procurement is an advanced surgical procedure that is performed in highly specialized centers. Since its first report, not much progress has been endeavored for that procedure.

Methods

We planned to include all the randomized and comparative nonrandomized studies. Patients’ population: live donors who are submitted to organ procurement via laparoscopy.

Results

Out of 5,636 records retrieved from the literature, only seven nonrandomized studies were included in this review, which encompassed 418 patients, 151 patients of whom underwent laparoscopic procurement. The quality scores for the included studies ranged from 66 to 76 %. The operative time was significantly shorter in the conventional open group (SD = 0.863, 95 % CI 0.107–1.819). Blood loss in the laparoscopic group was comparable with the conventional open approach (SD = −0.307, 95 % CI −0.807 to 0.192). In subgroup analysis, laparoscopy was protective against blood loss in laparoscopic parenchymal dissection (SD = −1.168, 95 % CI −1.758 to −0.577). The hospital stay was equal in both groups. Patients in laparoscopic group consumed fewer analgesics compared with conventional open group (SD = −0.33, 95 % CI −0.63 to −0.03). Analgesics use was lower in the laparoscopic group compared with the conventional approach. The rate of Clavien complications was equal in both groups (OR 0.721, 95 % CI 0.303–1.716). No difference was found between subgroup analysis based on the harvested liver lobe. Funnel plot and statistical methods used revealed low probability of publication BIAS.

Conclusions

Live donor laparoscopic liver procurement could be as safe as the conventional open approach. Lower blood loss and lower consumtion of analgesics might be offered in the laparoscopic approach.

Keywords

Abdominal Digestive Hepatobiliare (liver) Transplantation Surgical Laparoscopic Live donor Liver transplantation 

Notes

Acknowledgments

On the other hand, the authors would like to acknowledge that access to full text manuscripts was provided via institutional access of the INSERM; U785, Centre Hepatobiliare, Paul Brousse Hospital, Villejuif, France.

Disclosures

Mohamed Bekheit, Philipe-Abrahim Khafagy, Petru Bucur, Khaled Katri, Ahmed Elgendi, Wael Nabil Abdel-salam, Eric Vibert, and El-said El-kayal have no conflict of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Mohamed Bekheit
    • 1
    • 2
    • 3
    Email author
  • Philipe-Abrahim Khafagy
    • 4
  • Petru Bucur
    • 3
  • Khaled Katri
    • 5
  • Ahmed Elgendi
    • 5
  • Wael Nabil Abdel-salam
    • 5
  • Eric Vibert
    • 3
  • El-said El-kayal
    • 5
  1. 1.Minimal Invasive Surgery Unit, Department of SurgeryEl Kabbary General Hospital, El KabbaryAlexandriaEgypt
  2. 2.CIRE Plateform, INRA Centre Val de LoireNouzillyFrance
  3. 3.INSERM, Unit 785, Centre Hepatobiliaire, Paul Brousse HospitalVillejuifFrance
  4. 4.Department of RadiologyLe Raincy-Montfermeil HospitalMonfermeilFrance
  5. 5.HPB Surgery Unit, Department of Surgery, Faculty of Medicine, Alexandria Main University HospitalsAlexandria UniversityAlexandriaEgypt

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