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. 2023 Apr 17;12(8):2904.
doi: 10.3390/jcm12082904.

Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis

Chunyang Mu  1 , Chuwen Chen  1 , Jianghong Wan  2 , Guoxin Chen  3 , Jing Hu  4 , Tianfu Wen  1
Affiliations

Minimally Invasive Donors Right Hepatectomy versus Open Donors Right Hepatectomy: A Meta-Analysis

Chunyang Mu et al. J Clin Med. .

Abstract

Background: How to obtain a donor liver remains an open issue, especially in the choice of minimally invasive donors right hepatectomy versus open donors right hepatectomy (MIDRH versus ODRH). We conducted a meta-analysis to clarify this question.

Methods: A meta-analysis was performed in PubMed, Web of Science, EMBASE, Cochrane Central Register, and ClinicalTrials.gov databases. Baseline characteristics and perioperative outcomes were analyzed.

Results: A total of 24 retrospective studies were identified. For MIDRH vs. ODRH, the operative time was longer in the MIDRH group (mean difference [MD] = 30.77 min; p = 0.006). MIDRH resulted in significantly less intraoperative blood loss (MD = -57.86 mL; p < 0.00001), shorter length of stay (MD = -1.22 days; p < 0.00001), lower pulmonary (OR = 0.55; p = 0.002) and wound complications (OR = 0.45; p = 0.0007), lower overall complications (OR = 0.79; p = 0.02), and less self-infused morphine consumption (MD = -0.06 days; 95% CI, -1.16 to -0.05; p = 0.03). In the subgroup analysis, similar results were observed in pure laparoscopic donor right hepatectomy (PLDRH) and the propensity score matching group. In addition, there were no significant differences in post-operation liver injury, bile duct complications, Clavien-Dindo ≥ 3 III, readmission, reoperation, and postoperative transfusion between the MIDRH and ODRH groups.

Discussion: We concluded that MIDRH is a safe and feasible alternative to ODRH for living donators, especially in the PLDRH group.

Keywords: laparoscopic; laparoscopic-assisted; liver transplantation; meta-analysis; open living donor resection; right living donor resection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of study identification and selection.
Figure 2
Figure 2
Forest plot of comparison of MIDRH versus ODRH for age [4,5,6,7,12,13,14,15,16,17,19,20,21,22,23,25,26,27,28,29,30,31]. *: Different data in the same article.
Figure 3
Figure 3
Forest plot of comparison of MIDRH versus ODRH for gender [1,4,5,6,7,12,13,14,15,17,18,19,20,21,22,23,24,25,26,27,29,30,31]. *: Different data in the same article.
Figure 4
Figure 4
Forest plot comparison of MIDRH versus ODRH for intraoperative blood loss [4,5,6,7,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. *: Different data in the same article.
Figure 5
Figure 5
Forest plot comparison of MIDRH versus ODRH for operative time [4,5,7,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. *: Different data in the same article. *: Different data in the same article.
Figure 6
Figure 6
Forest plot and funnel plot comparison of MIDRH versus ODRH for length of hospital stay [4,5,7,12,13,14,16,17,18,19,20,21,22,23,24,25,27,29,30,31]. *: Different data in the same article.
Figure 7
Figure 7
Forest plot comparison of MIDRH versus ODRH for pulmonary complications [4,5,12,13,14,15,16,17,19,20,21,22,24,26,27,30]. *: Different data in the same article.
Figure 8
Figure 8
Forest plot comparison of MIDRH versus ODRH for postoperative transfusion [5,12,15,19,20,21,25,29]. *: Different data in the same article.
Figure 9
Figure 9
Forest plot and funnel plot comparison of MIDRH versus ODRH for wound complication [4,5,12,13,14,15,16,17,18,20,21,22,23,24,25,26,27,30,31]. *: Different data in the same article.
Figure 10
Figure 10
Forest plot and funnel plot comparison of MIDRH versus ODRH for overall complications [4,5,7,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,29,30,31]. *: Different data in the same article.
Figure 11
Figure 11
Forest plot and funnel plot comparison of MIDRH versus ODRH for self-infused morphine pump (days) [12,16,19,21].
See this image and copyright information in PMC

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