PURPOSE: LRLT in children is a method to provide organs for transplantation. We report 2 cases of LLLS for pediatric LRLT. METHOD: Donor position: lithotomy with surgeon in French position. Trocars: three 12 mm, placed 2 cm upper the supra-umbilical mid-line and sub-costal bi-lateral on the nipple lines; one 5 mm in epigastrium. Special instrumentation: harmonic scissor, ligasure®, Hem-O-Lock clips, and Endo Catch-II® bag. Main steps: division of round, falciform, left triangular ligaments and of lesser omentum; inspection of anatomy; hepatic hilum dissection with exposure of the left hepatic artery; dissection of the right side of the falciform ligament with exposure of the left branch of the portal vein; dissection of the Arantius’ ligament and exposure of the left hepatic vein; parenchymal dissection with hilar plate and left biliary duct(s) section; Pfannestiel incision; placement of the graft (S2-3) into an Endo Catch-II® bag; vessels transection with endoTA; graft extraction. RESULTS: Case 1. Donor: 19 year-old woman (w=67 kg, h=165 cm). Operation time was 495 min; total ischemia time (TIT) 38 min, and warm ischemia time (WIT) 7 min. No blood loss. Postop course uneventful: after 3 months donor remains asymptomatic with normal liver function. Recipient:10-month-old girl affected by sclerosing cholangitis, (PELD=23); after 3 months of follow-up the recipient is well with normal liver function. Case 2. Donor: 25 year-old woman (w=53 kg, h=150 cm). Operation time was 405 min, TIT 43 min, and WIT 6 min. No blood loss; Postop course and follow up uneventful. Recipient: 11-month-old girl affected by biliary atresia (PELD=10); after a 1 month of follow-up she’s alive and well with normal liver function. CONCLUSION: No donor’s morbidity or mortality was observed. The laparoscopic pediatric LDLT is a safe and feasible procedure that should be considered in experienced centers with advanced laparoscopic expertise.

Spada, M., Boggi, U., Pagano, D., Echeverri, G.J., Bartoccelli, C., Catalano, P., et al. (2011). LAPAROSCOPIC LEFT LIVER SECTIONECTOMY (LLLS) FOR PEDIATRIC LIVING RELATED LIVER TRANSPLANTATION (LRLT).. In Abstracts of the International Pediatric Transplant Association (IPTA) 6th Congress on Pediatric Transplantation. June 25-28, 2011. Montreal, Canada.. Wiley-Blackwell.

LAPAROSCOPIC LEFT LIVER SECTIONECTOMY (LLLS) FOR PEDIATRIC LIVING RELATED LIVER TRANSPLANTATION (LRLT).

CATALANO, Pieralba;
2011-01-01

Abstract

PURPOSE: LRLT in children is a method to provide organs for transplantation. We report 2 cases of LLLS for pediatric LRLT. METHOD: Donor position: lithotomy with surgeon in French position. Trocars: three 12 mm, placed 2 cm upper the supra-umbilical mid-line and sub-costal bi-lateral on the nipple lines; one 5 mm in epigastrium. Special instrumentation: harmonic scissor, ligasure®, Hem-O-Lock clips, and Endo Catch-II® bag. Main steps: division of round, falciform, left triangular ligaments and of lesser omentum; inspection of anatomy; hepatic hilum dissection with exposure of the left hepatic artery; dissection of the right side of the falciform ligament with exposure of the left branch of the portal vein; dissection of the Arantius’ ligament and exposure of the left hepatic vein; parenchymal dissection with hilar plate and left biliary duct(s) section; Pfannestiel incision; placement of the graft (S2-3) into an Endo Catch-II® bag; vessels transection with endoTA; graft extraction. RESULTS: Case 1. Donor: 19 year-old woman (w=67 kg, h=165 cm). Operation time was 495 min; total ischemia time (TIT) 38 min, and warm ischemia time (WIT) 7 min. No blood loss. Postop course uneventful: after 3 months donor remains asymptomatic with normal liver function. Recipient:10-month-old girl affected by sclerosing cholangitis, (PELD=23); after 3 months of follow-up the recipient is well with normal liver function. Case 2. Donor: 25 year-old woman (w=53 kg, h=150 cm). Operation time was 405 min, TIT 43 min, and WIT 6 min. No blood loss; Postop course and follow up uneventful. Recipient: 11-month-old girl affected by biliary atresia (PELD=10); after a 1 month of follow-up she’s alive and well with normal liver function. CONCLUSION: No donor’s morbidity or mortality was observed. The laparoscopic pediatric LDLT is a safe and feasible procedure that should be considered in experienced centers with advanced laparoscopic expertise.
Settore MED/18 - Chirurgia Generale
15-ago-2011
Congress of the International Pediatric Transplant Association
Montreal
25-28 giugno 2011
6th
2011
1
http://www.ncbi.nlm.nih.gov/pubmed/21830324
Spada, M., Boggi, U., Pagano, D., Echeverri, G.J., Bartoccelli, C., Catalano, P., et al. (2011). LAPAROSCOPIC LEFT LIVER SECTIONECTOMY (LLLS) FOR PEDIATRIC LIVING RELATED LIVER TRANSPLANTATION (LRLT).. In Abstracts of the International Pediatric Transplant Association (IPTA) 6th Congress on Pediatric Transplantation. June 25-28, 2011. Montreal, Canada.. Wiley-Blackwell.
Proceedings (atti dei congressi)
Spada, M; Boggi,U; Pagano, D; Echeverri,GJ; Bartoccelli,C; Catalano,P;Ricotta,C; Cintorino,D; Li Petri,S; di Francesco,F; Riva,S; Gruttadauria,S; Gridelli, BG
File in questo prodotto:
File Dimensione Formato  
LLS LRLTx abstract.pdf

accesso aperto

Dimensione 9.12 MB
Formato Adobe PDF
9.12 MB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10447/84863
Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact