Laparoscopy-Assisted versus Open Hepatectomy for Live Liver Donor: Systematic Review and Meta-Analysis

OBJECTIVE: To assess the feasibility, safety, and potential benefits of laparoscopy-assisted living donor hepatectomy (LADH) in comparison with open living donor hepatectomy (ODH) for liver transplantation. BACKGROUND: LADH is becoming increasingly common for living donor liver transplant around the world. We aim to determine the efficacy of LADH and compare it with ODH. METHODS: A systematic search on PubMed, Embase, Cochrane Library, and Web of Science was conducted in May 2017. RESULTS: Nine studies were suitable for this analysis, involving 979 patients. LADH seemed to be associated with increased operation time (WMD = 24.85 min; 95% CI: −3.01~52.78, P = 0.08), less intraoperative blood loss (WMD = −59.92 ml; 95% CI: −94.58~−25.27, P = 0.0007), similar hospital stays (WMD = −0.47 d; 95% CI: −1.78~0.83, P = 0.47), less postoperative complications (RR = 0.70, 95% CI: 0.51~0.94, P = 0.02), less analgesic use (SMD = −0.22; 95% CI: −0.44~−0.11, P = 0.04), similar transfusion rates (RR = 0.82; 95% CI: 0.24~3.12, P = 0.82), and similar graft weights (WMD = 7.31 g; 95% CI: −23.45~38.07, P = 0.64). CONCLUSION: Our results indicate that LADH is a safe and effective technique and, when compared to ODH.