caa a22 4500 445796456 CHVBK 20180317145127.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10620-011-1622-1 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1622-1 Donor Hepatectomy for Living Donor Liver Transplantation: Learning Steps and Surgical Outcome [Elektronische Daten] [Shigeru Marubashi, Hiroaki Nagano, Hiroshi Wada, Shogo Kobayashi, Hidetoshi Eguchi, Yutaka Takeda, Masahiro Tanemura, Yuichiro Doki, Masaki Mori] Background and Aim: Complications associated with live liver donor surgery should be minimized. There is little information on the impact of team experience and learning on the surgical outcome. The aim of this study was to clarify the impact of team experience in a single center on the outcome of live donor hepatectomy. Methods: Graft livers consisted of 56 right lobes, 40 left lobes with/without caudate, 36 left lateral section (LLS), and 11 right posterior section (RPS). Surgeries were divided according to the time of execution: era I (n=50), era II (n=50) and era III (n=43). Results: No postoperative mortality was recorded. Blood loss steadily decreased and operation time decreased after era II (P<0.0001). The overall frequency of postoperative morbidities by the Clavien system was significantly less for LLS graft [P=0.009, right lobe (42.9%) vs. LLS (13.9%)]. Multivariate risk factor analysis showed that donors in recent years were at low risk of morbidity and bile leakage (P=0.025 and 0.010, respectively). There was less impact for team experience on the outcome in LLS graft than other types of grafts. Conclusion: Our analysis demonstrated several learning steps in live liver donor surgery and confirmed their positive impact on surgical outcome. Springer Science+Business Media, LLC, 2011 Living donor nationallicence Liver transplant nationallicence Hepatectomy nationallicence Postoperative morbidity nationallicence Surgical experience nationallicence BMI : Body mass index nationallicence DIC-CT : Drip-infusion cholangiography computed tomography nationallicence LDLT : Living donor liver transplantation nationallicence LLD : Live liver donor nationallicence MHV : Middle hepatic vein nationallicence MD-CT scan : Multi-detector row-computed tomography scan nationallicence POD : Postoperative day nationallicence PT-INR : Prothrombin time - international normalized ratio nationallicence SLV : Standard liver volume nationallicence Marubashi Shigeru Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Nagano Hiroaki Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Wada Hiroshi Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Kobayashi Shogo Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Eguchi Hidetoshi Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Takeda Yutaka Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Tanemura Masahiro Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Doki Yuichiro Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Mori Masaki Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2482-2490 0163-2116 56:8<2482 2011 56 10620 https://doi.org/10.1007/s10620-011-1622-1 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1622-1 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Marubashi Shigeru Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Nagano Hiroaki Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Wada Hiroshi Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Kobayashi Shogo Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Eguchi Hidetoshi Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Takeda Yutaka Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Tanemura Masahiro Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Doki Yuichiro Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 700 1- Mori Masaki Department of Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, 565-0871, Suita City, Osaka, Japan aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2482-2490 0163-2116 56:8<2482 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer