Detailed Abstract
[E-poster - Liver (Transplantation)]
[EP 037] Diaphragmatic Hernia after Living-donor Hepatectomy: a 10-year Single-center Case Series
Minha CHOI 1, Sung-Gyu LEE 1, Shin HWANG 1, Chul-Soo AHN 1, Ki-hun KIM 1, Deok-Bog MOON 1, Tea-Yong HA 1, Gi-Won SONG 1, Gil-Chun PARK 1, Young-In YOON 1, Woo-Hyoung KANG 1, EUN-KYOUNG JWA 1, Byeong-Gon NA 1, Sung-Min KIM 1, Rak-Kyun OH 1, Hyo Jung KO 1, Sang-Hoon KIM 1, I-ji JEONG 1, Dong-Hwan JUNG 1
1 Division of Liver Transplantation And Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, REPUBLIC OF KOREA
Background : Acquired diaphragmatic hernia (DH) is a rare and potentially fetal complication after living-donor hepatectomy (LDH). This study aims to evaluate the incidence and clinical outcomes of diaphragmatic hernia after LDH.
Methods : Cases of 3989 living-donors who underwent LDH in Asan Medical Center in Seoul between January 2014 and December 2023 were retrospectively reviewed. Demographic information, operative data, admission types (emergency or elective), imaging methods used for diagnosis, surgical methods for repair of DH, and follow-up data were recorded from electronic medical records. The incidence of DH was analysed in periods before and after use of Aquamatis, a saline-coupled bipolar sealer.
Results : Postoperative DH was occurred in 14 patients (0.35%) in our study. Thirteen patients underwent right LDH and developed right-sided DH, and one patient underwent left LDH and developed left-sided DH. The incidence of DH was 0.25% in the pre-Aquamatis period and more than doubled to 0.6% in the post-Aquamatis period. The median time from the first surgery to diagnosis of DH was 15.8 months (range, 2.9-95.3 months). Eleven patients with severe abdomen pain or ileus underwent emergent operation for DH repair, and small bowel resection and anatomosis was performed to one patient due to severe bowel ischemia.
Conclusions : Early recognition and surgical repair of DH following LDH should be considered for living-donor with unexplained abdominal or thoracic symptoms. In addition, care should be taken when using Aquamatis around the diaphragm in LDH to minimise potential thermal damage.
Methods : Cases of 3989 living-donors who underwent LDH in Asan Medical Center in Seoul between January 2014 and December 2023 were retrospectively reviewed. Demographic information, operative data, admission types (emergency or elective), imaging methods used for diagnosis, surgical methods for repair of DH, and follow-up data were recorded from electronic medical records. The incidence of DH was analysed in periods before and after use of Aquamatis, a saline-coupled bipolar sealer.
Results : Postoperative DH was occurred in 14 patients (0.35%) in our study. Thirteen patients underwent right LDH and developed right-sided DH, and one patient underwent left LDH and developed left-sided DH. The incidence of DH was 0.25% in the pre-Aquamatis period and more than doubled to 0.6% in the post-Aquamatis period. The median time from the first surgery to diagnosis of DH was 15.8 months (range, 2.9-95.3 months). Eleven patients with severe abdomen pain or ileus underwent emergent operation for DH repair, and small bowel resection and anatomosis was performed to one patient due to severe bowel ischemia.
Conclusions : Early recognition and surgical repair of DH following LDH should be considered for living-donor with unexplained abdominal or thoracic symptoms. In addition, care should be taken when using Aquamatis around the diaphragm in LDH to minimise potential thermal damage.
SESSION
E-poster
E-Session 03/21 ALL DAY