Pure Laparoscopic Versus Open Approach for Living Donor Right Hepatectomy: A Systematic Review and Meta-Analysis

作者：Yufu Peng, Bo Li, Hongwei Xu, Kang Chen, Yonggang Wei, Fei Liu · 发表于：Journal of Laparoendoscopic & Advanced Surgical Techniques · 年份：2021 · DOI：10.1089/lap.2021.0583 · 被引用次数：11 · 研究领域：Organ Transplantation Techniques and Outcomes、Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease and Transplantation

Background: Pure laparoscopic liver donor right hepatectomy (LLDRH) remains challenging, and its value is still unclear compared with open liver donor right hepatectomy (OLDRH). Objective: To provide comprehensive evidence about the safety and efficacy of LLDRH. Methods: The MEDLINE, Embase, Web of Science, and Cochrane Library electronic databases were searched from the date of inception to July 2021. A fixed-effects or random-effects model was used to analyze the pooled data by using Review Manager Version 5.3. Results: A total of 1940 patients from 6 studies were enrolled in this meta-analysis. For perioperative outcomes of donors, LLDRH had a longer operative time than OLDRH (weighted mean difference [WMD] = 29.75 [4.23–55.26] minutes, P = .02), but it had lower overall morbidity (odds ratio [OR] = 0.67 [0.45–0.99], P = .04), fewer pulmonary complications (OR = 0.47 [0.29–0.76], P = .002), and shorter hospital stays (WMD = −1, P < .001) than OLDRH. However, major complications, biliary complications, portal vein problems, and intra-abdominal bleeding were comparable between the 2 groups. With regard to the postoperative data of recipients, the risks of biliary problems, hepatic artery problems, portal vein problems, hepatic vein problems, and postoperative liver failure were similar between the 2 groups. Conclusions: LLDRH for living donors is safe and effective, and it offers superior perioperative outcomes to OLDRH.