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[病历讨论] 纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

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发表于 2022-12-31 00:00:29 | 显示全部楼层 |阅读模式

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与传统的开放式供体右肝切除术 (CODRH) 相比,纯腹腔镜供体右肝切除术 (PLDRH) 可为供体提供更好的手术结果。 然而,程序的复杂性通常使移植团队不愿意执行它,尤其是在小批量移植中心。 比较了 PLDRH 和 CODRH 的结果,以证明 PLDRH 在小容量移植计划中的可行性。

对2015年1月至2021年3月在清迈大学医院进行的成人肝移植进行了回顾性研究,将患者分为PLDRH组和CODRH组。 比较两组供者和受者的基线特征、手术参数和术后并发症。

30 名患者在所选日期之间接受了供体肝切除术(9 名 PLDRH 患者和 21 名 CODRH 患者)。 2组的基线特征无显著差异。 PLDRH组中位移植物体积为693.8 mL,与CODRH组(726.5 mL)无显著差异 PLDRH组手术时间长于CODRH组,但差异无统计学意义(487.5 min 对比 425.0 分钟,p = 0.197)。 两组间的总体并发症发生率无显著差异(33.3% vs 22.2%,p = 0.555)。 此外,对于接受者,主要并发症的发生率在各组之间没有显著差异(71.3 对 55.6%,p = 0.792)。

即使在这个低容量移植项目的背景下,其工作人员在微创肝胆外科手术方面具有丰富的经验,PLDRH 在供体和受体的围手术期结果方面也显示出与 CODRH 相似的结果。

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

患者、手术团队和端口位置

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

血管流入识别和缺血分界。 a 右肝动脉和右门静脉分别用红色和蓝色松紧带包裹,然后用 endo-bulldog 夹暂时控制。 b 通过叠加的近红外成像显示和标记的缺血分界线。 c 腹腔镜超声用于识别肝中静脉

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

肝实质横断结扎后肝中静脉术前计划

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

纯腹腔镜和开放供体右肝切除术的比较结果:来自东南亚移植中心的一份报告

纯腹腔镜供体右肝切除术中实时 ICG 胆管造影辅助胆管切开
 楼主| 发表于 2022-12-31 00:00:30 | 显示全部楼层
1. Ciria R, Cherqui D, Geller DA, Briceno J, Wakabayashi G. Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg. 2016;263:761–777. doi: 10.1097/SLA.0000000000001413.   
2. Cherqui D, Soubrane O, Husson E, Barshasz E, Vignaux O, Ghimouz M, Branchereau S, Chardot C, Gauthier F, Fagniez PL, Houssin D. Laparoscopic living donor hepatectomy for liver transplantation in children. Lancet. 2002;359:392–396. doi: 10.1016/S0140-6736(02)07598-0.   
3. Soubrane O, de Rougemont O, Kim KH, Samstein B, Mamode N, Boillot O, Troisi RI, Scatton O, Cauchy F, Lee SG, Griesemer A, Ahmed Z, Clavien PA, Cherqui D (2015) Laparoscopic living donor left lateral sectionectomy: a new standard practice for donor hepatectomy. Ann Surg 262: 757–761 (discussion 761–753)
4. Hong SK, Tan MY, Worakitti L, Lee JM, Cho JH, Yi NJ, Lee KW, Suh KS. Pure laparoscopic versus open right hepatectomy in live liver donors: a propensity score-matched analysis. Ann Surg. 2020;275(1):e206–12. doi: 10.1097/SLA.0000000000003914.   
5. Jeong JS, Wi W, Chung YJ, Kim JM, Choi GS, Kwon CHD, Han S, Gwak MS, Kim GS, Ko JS. Comparison of perioperative outcomes between pure laparoscopic surgery and open right hepatectomy in living donor hepatectomy: propensity score matching analysis. Sci Rep. 2020;10:5314. doi: 10.1038/s41598-020-62289-0.   
6. Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O'Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM. Recommendations for laparoscopic liver resection: a report from the second International consensus conference held in Morioka. Ann Surg. 2015;261:619–629.  
7. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009;250:187–196. doi: 10.1097/SLA.0b013e3181b13ca2.   
8. Kim KH, Kang SH, Jung DH, Yoon YI, Kim WJ, Shin MH, Lee SG. Initial outcomes of pure laparoscopic living donor right hepatectomy in an experienced adult living donor liver transplant center. Transplantation. 2017;101:1106–1110. doi: 10.1097/TP.0000000000001637.   
9. Lapisatepun W, Hong SK, Hong K, Han ES, Lee JM, Yi NJ, Lee KW, Suh KS. Influence of large grafts weighing >/= 1000 g on outcome of pure laparoscopic donor right hepatectomy. J Gastrointest Surg. 2020;25(8):1980–8. doi: 10.1007/s11605-020-04837-7.   
10. van de Poll MC, Derikx JP, Buurman WA, Peters WH, Roelofs HM, Wigmore SJ, Dejong CH. Liver manipulation causes hepatocyte injury and precedes systemic inflammation in patients undergoing liver resection. World J Surg. 2007;31:2033–2038. doi: 10.1007/s00268-007-9182-4.   
11. van den Broek MA, Shiri-Sverdlov R, Schreurs JJ, Bloemen JG, Bieghs V, Rensen SS, Dejong CH, Olde Damink SW. Liver manipulation during liver surgery in humans is associated with hepatocellular damage and hepatic inflammation. Liver Int. 2013;33:633–641. doi: 10.1111/liv.12051.   
12. Lee KW, Hong SK, Suh KS, Kim HS, Ahn SW, Yoon KC, Lee JM, Cho JH, Kim H, Yi NJ. One hundred fifteen cases of pure laparoscopic living donor right hepatectomy at a single center. Transplantation. 2018;102:1878–1884. doi: 10.1097/TP.0000000000002229.   
13. Kasai M, Cipriani F, Gayet B, Aldrighetti L, Ratti F, Sarmiento JM, Scatton O, Kim KH, Dagher I, Topal B, Primrose J, Nomi T, Fuks D, Abu Hilal M. Laparoscopic versus open major hepatectomy: a systematic review and meta-analysis of individual patient data. Surgery. 2018;163:985–995. doi: 10.1016/j.surg.2018.01.020.   
14. Kwon CHD, Choi GS, Kim JM, Cho CW, Rhu J, Soo Kim G, Sinn DH, Joh JW. Laparoscopic donor hepatectomy for adult living donor liver transplantation recipients. Liver Transpl. 2018;24:1545–1553. doi: 10.1002/lt.25307.   
15. Rotellar F, Pardo F, Benito A, Zozaya G, Marti-Cruchaga P, Hidalgo F, Lopez L, Inarrairaegui M, Sangro B, Herrero I. Totally laparoscopic right hepatectomy for living donor liver transplantation: analysis of a preliminary experience on 5 consecutive cases. Transplantation. 2017;101:548–554. doi: 10.1097/TP.0000000000001532.   
16. Zhang W, Xu L, Zhang J, Che X. Safety and feasibility of laparoscopic living donor right hepatectomy for adult liver transplantation: a meta-analysis. HPB (Oxford) 2020;23:344–358. doi: 10.1016/j.hpb.2020.10.030.   
17. Miller CM, Quintini C, Dhawan A, Durand F, Heimbach JK, Kim-Schluger HL, Kyrana E, Lee SG, Lerut J, Lo CM, Pomfret EA. The international liver transplantation society living donor liver transplant recipient guideline. Transplantation. 2017;101:938–944. doi: 10.1097/TP.0000000000001571.   
18. Hong SK, Lee KW, Choi Y, Kim HS, Ahn SW, Yoon KC, Kim H, Yi NJ, Suh KS. Initial experience with purely laparoscopic living-donor right hepatectomy. Br J Surg. 2018;105:751–759. doi: 10.1002/bjs.10777.   
19. Hong SK, Shin E, Lee KW, Yoon KC, Lee JM, Cho JH, Yi NJ, Suh KS. Pure laparoscopic donor right hepatectomy: perspectives in manipulating a flexible scope. Surg Endosc. 2019;33:1667–1673. doi: 10.1007/s00464-018-6594-1.   
20. Hong SK, Suh KS, Yoon KC, Lee JM, Cho JH, Yi NJ, Lee KW. The learning curve in pure laparoscopic donor right hepatectomy: a cumulative sum analysis. Surg Endosc. 2019;33:3741–3748. doi: 10.1007/s00464-019-06668-3.   
21. Lee JM, Shehta A, Suh KS, Hong SK, Yoon KC, Cho JH, Yi NJ, Lee KW. Guidance for optimal port placement in pure 3-dimensional laparoscopic donor right hepatectomy. Liver Transpl. 2019;25:1714–1722. doi: 10.1002/lt.25609.   
22. Ha TY, Hwang S, Ahn CS, Kim KH, Moon DB, Song GW, Jung DH, Park GC, Namgoong JM, Park CS, Park YH, Park HW, Kang SH, Jung BH, Lee SG. Role of hand-assisted laparoscopic surgery in living-donor right liver harvest. Transplant Proc. 2013;45:2997–2999. doi: 10.1016/j.transproceed.2013.08.053.   
23. Zhang B, Pan Y, Chen K, Maher H, Chen MY, Zhu HP, Zhu YB, Dai Y, Chen J, Cai X-j. Laparoscopy-assisted versus open hepatectomy for live liver donor: systematic review and meta-analysis. Can J Gastroenterol Hepatol. 2017;2017:2956749. doi: 10.1155/2017/2956749.   
24. Yoo S, Jang EJ, Yi N-J, Kim GH, Kim DH, Lee H, Jung C-W, Ryu HG. Effect of institutional case volume on in-hospital mortality after living donor liver transplantation: analysis of 7073 cases between 2007 and 2016 in Korea. Transplantation. 2019;103:952–958. doi: 10.1097/TP.0000000000002394.   
25. Li C, Mi K, Wen T, Yan L, Li B, Yang J, Xu M, Wang WT, Wei Y. A learning curve for living donor liver transplantation. Dig Liver Dis. 2012;44:597–602. doi: 10.1016/j.dld.2012.01.016.   
26. Cheng CW, Liu FC, Lin JR, Tsai YF, Chen HP, Yu HP. The impact of hospital/surgeon volume on acute renal failure and mortality in liver transplantation: a nationwide cohort study. PLoS ONE. 2016;11:e0162992. doi: 10.1371/journal.pone.0162992.   
27. Kim SH, Cho SY, Park SJ, Lee KW, Han SS, Lee SA, Park JW, Kim CM. Learning curve for living-donor liver transplantation in a fledgling cancer center. Transpl Int. 2009;22:1164–1171. doi: 10.1111/j.1432-2277.2009.00934.x.   
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