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Surgical Endoscopy

, Volume 31, Issue 11, pp 4834–4835 | Cite as

Pure 3D laparoscopic living donor right hemihepatectomy in a donor with separate right posterior and right anterior hepatic ducts and portal veins

  • Suk Kyun Hong
  • Kyung-Suk SuhEmail author
  • Hyo-Sin Kim
  • Kyung Chul Yoon
  • Sung-Woo Ahn
  • Dongkyu Oh
  • Hyeyoung Kim
  • Nam-Joon Yi
  • Kwang-Woong Lee
Open Access
Video

Abstract

Background

Despite increases in the performance of pure laparoscopic living donor hepatectomy, variations in the bile duct or portal vein have been regarded as relative contraindications to this technique [1, 2, 3]. This report describes a donor with separate right posterior and right anterior hepatic ducts and portal veins who underwent pure laparoscopic living donor right hemihepatectomy, integrated with 3D laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography [1, 4, 5].

Methods

A 50-year-old man offered to donate part of his liver to his older brother, who required a transplant for hepatitis B-associated liver cirrhosis and hepatocellular carcinoma. Donor height was 178.0 cm, body weight was 82.7 kg, and body mass index was 26.1 kg/m2. Preoperative computed tomography and magnetic resonance cholangiopancreatography showed that the donor had separate right posterior and right anterior hepatic ducts and portal veins. The entire procedure was performed under 3D laparoscopic view. Following intravenous injections of 0.05 mg/kg ICG, ICG near-infrared fluorescence camera was used to demarcate the exact transection line and determine the optimal bile duct division point.

Results

The total operation time was 443 min; the donor required no transfusions and experienced no intraoperative complications. The graft weighed 1146 g with a graft-to-recipient weight ratio of 1.88%. The optimal bile duct division point was identified using ICG fluorescence cholangiography, and the bile duct was divided with good patency without any stricture. The right anterior and posterior portal veins were transected with endostaplers without any torsion. The patient was discharged on postoperative day 8, with no complications.

Conclusion

Using a 3D view and ICG fluorescence cholangiography, pure 3D laparoscopic living donor right hemihepatectomy is feasible in a donor with separate right posterior and right anterior hepatic ducts and portal veins.

Keywords

Living donor liver transplantation Laparoscopy Right hemihepatectomy Indocyanine green 

Supplementary material

Supplementary material 1 (WMV 175649 kb)

References

  1. 1.
    Suh KS, Hong SK, Yi NJ, Lee KW, Kim HS, Yoon KC et al (2016) Pure 3-dimensional laparoscopic extended right hepatectomy in a living donor. Liver Transpl 22:1431–1436CrossRefPubMedGoogle Scholar
  2. 2.
    Soubrane O, Perdigao Cotta F, Scatton O (2013) Pure laparoscopic right hepatectomy in a living donor. Am J Transplant 13:2467–2471CrossRefPubMedGoogle Scholar
  3. 3.
    Han HS, Cho JY, Yoon YS, Hwang DW, Kim YK, Shin HK et al (2015) Total laparoscopic living donor right hepatectomy. Surg Endosc 29:184CrossRefPubMedGoogle Scholar
  4. 4.
    Velayutham V, Fuks D, Nomi T, Kawaguchi Y, Gayet B (2016) 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study. Surg Endosc 30:147–153CrossRefPubMedGoogle Scholar
  5. 5.
    Mizuno S, Isaji S (2010) Indocyanine green (ICG) fluorescence imaging-guided cholangiography for donor hepatectomy in living donor liver transplantation. Am J Transplant 10:2725–2726CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2017

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Authors and Affiliations

  • Suk Kyun Hong
    • 1
  • Kyung-Suk Suh
    • 1
    Email author
  • Hyo-Sin Kim
    • 1
  • Kyung Chul Yoon
    • 1
  • Sung-Woo Ahn
    • 1
  • Dongkyu Oh
    • 1
  • Hyeyoung Kim
    • 1
  • Nam-Joon Yi
    • 1
  • Kwang-Woong Lee
    • 1
  1. 1.Department of SurgerySeoul National University College of MedicineJongno-guKorea

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