Background : This study aimed to compare feasibility and safety of robotic donor right hepatectomy (RDRH) and laparoscopic donor right hepatectomy (LDRH) by evaluating long-term outcomes based on a single institution’s experience.

Methods : From March 2016 to June 2023, 117 who underwent RDRH and 118 donors who underwent LDRH were included in a single-center retrospective study. After performing 1:1 propensity score matching between both groups, 71 donor-recipient pairs were included in each group. We analyzed complications of donors and recipients, especially graft-related complications divided into early and late (within and later than 30 days) biliary complications and vascular complications.

Results : In matched cohort, RDRH group had a longer total operative time (P< 0.001), and graft-out time (P< 0.001), however, warm ischemic time was similar. Estimated blood loss (P< 0.001) was less in RDRH group. The rate of major complications in donors was similar. Bile duct (BD) variation had no significant difference however, the rate of multiple BD openings was higher (P< 0.001) and the rate of major complications in recipients was higher in LDRH groups (P= 0.011). The cumulative biliary complication rate was higher in LDRH groups (P= 0.010). Early biliary complications were not significantly different, however, late biliary complications were higher in LDRH groups (11.3 vs. 26.8%, P= 0.019).

Conclusions : RDRH showed similar postoperative complications compared to LDRH in donors, but late biliary complications in recipients were less compared to LDRH. It might be related to fewer multiple bile duct openings through robotic precise dissection and BD division.