Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2020; 8(23): 6103-6109
Published online Dec 6, 2020. doi: 10.12998/wjcc.v8.i23.6103
Laparoscopic left lateral sectionectomy in pediatric living donor liver transplantation by single-port approach: A case report
Hong-Yu Li, Lin Wei, Zhi-Gui Zeng, Wei Qu, Zhi-Jun Zhu
Hong-Yu Li, Lin Wei, Zhi-Gui Zeng, Wei Qu, Zhi-Jun Zhu, Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Zhu ZJ conceived and designed the study; Li HY was involved in concept/design, data collection, data analysis/interpretation, drafting the article and critical revision of the manuscript; Wei L, Zeng ZG and Qu W participated in performing the research; all authors gave final approval for the version to be submitted.
Supported by Capital Research Project for Specialty Clinical Application, No. Z181100001718220.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Jun Zhu, MD, PhD, Chief Doctor, Professor, Surgeon, Liver Transplantation Center, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China. zhu-zhijun@outlook.com
Received: June 10, 2020
Peer-review started: June 10, 2020
First decision: September 24, 2020
Revised: October 1, 2020
Accepted: October 20, 2020
Article in press: October 20, 2020
Published online: December 6, 2020
Processing time: 176 Days and 22.9 Hours
Abstract
BACKGROUND

Single-port laparoscopy has been used in a variety of abdominal operations. We report the first case of single-port laparoscopic left lateral sectionectomy in pediatric laparoscopic living donor liver transplantation.

CASE SUMMARY

A 28-year-old man volunteered for living liver donation to his daughter who was diagnosed with liver cirrhosis and portal hypertension after the Kasai procedure for biliary atresia. His body mass index was 20.5 kg/m2. Liver dynamic computed tomography showed: (1) Left lateral graft volume of 232.76 cm3 with a graft-to-recipient weight ratio of 2.59%; and (2) Right hepatic artery derived from the superior mesenteric artery. A single-port access system was placed through a transumbilical incision, including four trocars: two 12-mm ports for a camera and endoscopic stapler and two 5-mm working ports. Liver parenchyma was dissected by a Harmonic and Cavitron Ultrasonic Surgical Aspirator, while bipolar was used for coagulation. The bile duct was transected above the bifurcation by indocyanine green fluorescence cholangiography. The specimen was retrieved from the umbilical incision. The total operation time was 4 h without blood transfusion. The final graft weight was 233.6 g with graft-to-recipient weight ratio of 2.60%. The donor was discharged uneventfully on postoperative day 4.

CONCLUSION

Single-port laparoscopic left lateral sectionectomy is feasible in pediatric laparoscopic living donor liver transplantation in an experienced transplant center.

Keywords: Pediatric living donor liver transplantation; Laparoscopy; Single-port approach; Intraoperative indocyanine green fluorescence cholangiography; Treatment; Case report

Core Tip: Due to the accumulated experience of laparoscopic hepatectomy in living donor liver transplantation, laparoscopic left lateral sectionectomy (L-LLS) has been acknowledged as a standard practice in pediatric living donor liver transplantation. The single-port laparoscopic technique has been used in a variety of abdominal surgeries, especially the single-port L-LLS. We report the first case of L-LLS in pediatric laparoscopic living donor liver transplantation by the single-port approach, focusing on the surgical procedure and how to achieve feasible manipulation due to the challenge of little operative space through the transumbilical port.