Meta-Analysis of Laparoscopic versus Open Hepatectomy for Live Liver Donors

Objective To document the safety and efficacy of laparoscopic living donor hepatectomy in comparison with open liver resection for living donor liver transplantation. Methods Medline database, EMASE and Cochrane library were searched for original studies comparing laparoscopic living donor hepatectomy (LLDH) and open living donor hepatectomy (OLDH) by January 2015. Meta-analysis was performed to evaluate donors' perioperative outcomes. Results Nine studies met selection criteria, involving 1346 donors of whom 318 underwent LLDH and 1028 underwent OLDH. The Meta analysis demonstrated that LLDH group had less operative blood loss [patients 1346; WMD:-56.09 mL; 95%Cl:-100.28-(-11.90) mL; P= 0.01], shorter hospital stay [patients 737; WMD:-1.75 d; 95%Cl:-3.01-(-0.48) d; P= 0.007] but longer operative time (patients 1346; WMD: 41.05 min; 95%Cl: 1.91-80.19 min; P= 0.04), compared with OLDH group. There were no significant difference in other outcomes between LLDH and OLDH groups, including overall complication, bile leakage, postoperative bleeding, pulmonary complication, wound complication, time to dietary intake and period of analgesic use. Conclusions LLDH appears to be a safe and effective option for LDLT. It improves donors' perioperative outcomes as compared with OLDH.