Pure laparoscopic donor right hepatectomy in a living donor with type 3a biliary variation A case report

Rationale: With refinements in the operative technique, laparoscopic surgery has become the standard practice for liver resection. In the field of living donor liver transplantation, a few centers adopted laparoscopic surgery as an alternative to conventional open donor hepatectomy, and the application of pure laparoscopic donor right hepatectomy has been limited to the donors with simple, favorable biliary anatomy. Patient concerns: The candidate donor was a 19-year-old woman with type 3a bile duct variation. Interventions: After confirming precise cutting points under the guidance of a radiopaque marker rubber band, the bile ducts were divided and the remnant stumps were closed with suture and clipping using Hem-o-lok, respectively. Outcomes: The postoperative course was uneventful and she was satisfactory 6 months after surgery. Lessons: A laparoscopic donor hepatectomy for the living donor with biliary variation was feasible. Biliary variations are commonly encountered during living donor surgery, and we think that such variations in laparoscopic donor hepatectomy need to be overcome to expand the selection criteria.