Liver transplant: Living donor right hepatectomy

Donor procedure with a segment 6/7 and segment 8 veins and 2 ducts



02:12  Exposure & Left lobe mobilization

03:03  Portal dissection

04:47  Right lobe mobilization

06:40  Transection & extraction

11:25  Backbench and closure

Case description
  • The living donor was a 48 year old woman.
  • A previous cholecystectomy had been performed.
  • The transection plane extends from the junction of the right hepatic vein with the cava and extends through the gall bladder fossa to the pre-determined location of bile duct transection.
  • Intraoperative cholangiogram will confirm the bile duct transection location.
  • The right lobe graft will consist of segments V, VI, VII and VIII. Pre-op calculations estimated a volume of 812 cm³.
  • The remaining left lobe volume of 326 cm³ was calculated to be safe for the donor.
  • Two bile duct branches, 6/7 and 5/8 branches of the right hepatic duct, were transected, yielding a graft with two bile duct orifices.
  • The bile ducts were cut to leave good tissue for re-implantation. If the tissue is too thin, it will be difficult to sew, and may result in leakage.
  • The donor bile duct orifices were sutured closed with running 6-0 PDS suture, in such a manner as not to compromise the lumen for the common bile duct.
  • In addition to the right hepatic vein, significant segment 6/7 and segment 8 hepatic vein branches were preserved for the donor graft.
CT scans (venous phase)

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CT scans (arterial phase)

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