Comparison of Postoperative Outcome of Hepatectomy for Living Donors According to Three Different Incision

Comparison of Postoperative Outcome of Hepatectomy for Living Donors According to Three Different Incision: Conventional Incision vs Minimal Incision vs Transverse Incision Assisted by Laparoscopy

Living donor liver transplantation (LDLT) is an important option for patients with end-stage liver disease requiring liver transplantation. When performing LDLT, the safety and well being of donors is of the utmost importance. The conventional incision for donor hepatectomy is a right subcostal incision with a midline extension up to xiphoid. Minimally invasive liver surgery throughout a single 10 cm upper midline incision without laparoscopic assistance has been widely applied and considered to be safe and effective. Recently, laparoscopic and minimally invasive living donor hepatectomy via transverse incision has been suggested to reduce morbidity and the invasiveness of living donor hepatectomy. Although minimally invasive approach has become the surgical method of choice for many transplant centers, little data on comparing the impact of all three different type incision in living liver donors. In our center, the investigators have adopted three different incision according to surgical teams. The investigators undertook this study with the aims of comparing the pain and quality of life of donors according to type of three different incisions and assessing any benefits to the donor due to the smaller midline incision during the early postoperative period.

Inclusion Criteria:

• ASA (American Society of Anesthesiologists) physical status I-II,
• adult undergoing hepatectomy for living donors

Exclusion Criteria:

• known allergy to any of the drugs used in this study,
• bleeding diathesis,
• neurologic dysfunction (preexisting lower limb neurological deficit),
• recent systemic or local infections,
• history of drug use, or
• under treatment with opioids because of chronic pain