Pushing the frontiers of living donor right hepatectomy

Table 1 Modifications in technique and management of living donor right hepatectomy in the authors’ institution

Modifications	From case No. onwards
Use of an electric coagulator to pierce abdominal wall for a drainage tube instead of using a cutting end connected to a closed-suction drain	45
Upper midline incision above umbilicus	55
Dosage reduction of intravenous heparin given before graft removal from 50 IU/kg to 25 IU/kg	93
Use of surgical wound protector	112
Hanging maneuver from the start of liver parenchymal transection by initial Glisson’s approach	165
Intraoperative cholangiography replaced by MRC	165
No intensive care unit stay after surgery	167
No central venous catheterization	169
Bile duct cut just 2 mm to the right side of the confluence changed from 1 mm	200
Dosage reduction of intravenous heparin given before graft removal from 25 IU/kg to 5 IU/kg	271

MRC: Magnetic resonance cholangiography.

Table 2 Operative outcomes from studies for living donor right hepatectomy n (%)

Ref.	Number of donors	Blood loss (mL)	Operative time (min)	Morbidity	Mortality
Ito et al[64], 2003	200	260 (20-1670)	384 (198-672)	69 (34.5)	0
Chan et al[42], 2007	200	362 (42-1600)	468 (304-932)	41 (20.5)	1 (0.5)
Yi et al[9], 2007	83	491.9 ± 225.2	287.1 ± 42.4	65 (78.3)	0
Gruttadauria et al[7], 2008	75	NA	7.90 ± 1.75 h	23 (30.6)	0
Baker et al[65], 2009	66	484 ± 265	291 ± 55	14 (21.2)	0
Adcock et al[66], 2010	202	997 ± 484	443 ± 85	57 (28)	0
Azoulay et al[6], 2011	91	702 ± 593	283 ± 45	51 (56.0)	0
Kim et al[67], 2012	500	NA	339 ± 63	139 (27.8)	0
Nagai et al[68], 2012	58	367 ± 52	367 ± 52	14 (24.1)	0
Salah et al[69], 2012	100	485 ± 396	364 ± 60	38 (38)	1 (1)
Kim et al[10], 2013	300	300 (100-1400)	257 (146-414)	48 (16)	0
Facciuto et al[70], 2013	137	NA	NA	45 (33)	1 (0.7)

NA: Not available.