Total hepatectomy during living donor liver transplantation at 108 Military Central Hospital

  • Vu Van Quang Bệnh viện Trung ương Quân đội 108
  • Ho Van Linh 108 Military Central Hospital

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Keywords

Total hepatectomy, living donor liver transplant, high hilum dissection

Tóm tắt

Objective:  To evaluate the results and summarizing the experiences of total hepatectomy in living donor liver transplantation. Subject and method: A cross-sectional, descriptive study, over 165 cases of living donor liver transplantation at 108 Military Central Hospital from January 2019 to April 2023. Result: The average age of patients was 51.57 ± 13.19 years old, HBV infection rate was 70.9%. Indications for liver transplantation include acute liver failure (2.4%), acute on chronic liver failure (34%), decompensated cirrhosis (24.8%), hepatocellular carcinoma (37%), intrahepatic cholangiocarcinoma (1.2%), liver metastases from colon cancer (0.6%). High hilum dissection of the hepatic artery in continuity with the bile duct rate was 95.2%, individual dissection in 3% and total occlusion in 1.8% of cases. The left and middle hepatic veins trunk was divided before segment 1 dissection in 95.8% of patients. Average time of total hepatectomy was 148.12 ± 38.9 minutes, average blood loss during total hepatectomy was 867 ± 442ml. Conclusion: High hilum dissection of the hepatic artery in continuity with the bile duct combined with left and middle hepatic veins trunk divided before dissecting of the segment 1 is safe and feasible for total hepatectomy during living donor liver transplantation.

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Các tài liệu tham khảo

1. Ikegami T, Soejima Y, Taketomi A, Yoshizumi T, Harada N, Kayashima H, ... & Maehara Y (2008) Hilar anatomical variations in living-donor liver transplantation using right-lobe grafts. Digestive surgery 25(2): 117-123.
2. Lee KW, Joh JW, Kim SJ, Choi SH, Heo JS, Lee HH, ... & Lee SK (2004) High hilar dissection: New technique to reduce biliary complication in living donor liver transplantation. Liver transplantation 10(9): 1158-1162.
3. Abu-Gazala S, Olthoff KM, Goldberg DS, Shaked A & Abt P L (2016) En bloc hilar dissection of the right hepatic artery in continuity with the bile duct: A technique to reduce biliary complications after adult living-donor liver transplantation. Journal of gastrointestinal surgery 20: 765-771.
4. Vandana Khungar, Alyson N Fox, Robert S Brown, (2015) Current Indications, contraindications, delisting criteria, and timing for transplantation. Transplantation of the liver, third edition. Elsevier Saunders: 94-104.
5. Durand F, Levitsky J, Cauchy F, Gilgenkrantz H, Soubrane O, Francoz C (2019) Age and liver transplantation. Journal of Hepatology 70(4): 745-758.
6. Abdelshafy AA, Elsaid KM, Elghandour AM, Emam, DF (2020) En bloc high hilar dissection versus conventional hilar dissection in living donor liver transplantation donors: A comparative, single-center study. The Egyptian Journal of Surgery 39(3): 547-552.
7. Ikegami T, Shirabe K, Morita, K Soejima Y, Taketomi A, Yoshizumi T, Maehara Y (2011) Minimal hilar dissection prevents biliary anastomotic stricture after living donor liver transplantation. Transplantation 92(10): 1147-1151.
8. Terrault NA, Francoz C, Berenguer M, Charlton M, Heimbach J (2023) Liver transplantation 2023: Status report, current and future challenges. Clinical Gastroenterology and Hepatology.
9. Dueland S, Guren TK, Hagness M, Glimelius B, Line PD, Pfeiffer P, Tveit KM (2015) Chemotherapy or liver transplantation for nonresectable liver metastases from colorectal cancer? Annals of surgery 261(5): 956-960.
10. Soejima Y, Fukuhara T, Morita K, Yoshizumi T, Ikegami T, Yamashita Y, Maehara Y (2008) A simple hilar dissection technique preserving maximum blood supply to the bile duct in living donor liver transplantation. Transplantation 86(10): 1468-1469.