Background : Living donor liver transplantation plays an important role in the treatment of liver disease as an alternative to the lack of liver grafts. However, donors' safety remains a subject of controversy. Minimally invasive living donor hepatectomy is also receiving attention to reduce liver donor's post-operative pain and aid recovery. This study is for evaluating the learning curve of laparoscopic living liver donor hepatectomy performed by a single surgeon.

Methods : Living liver donors from 2014 to 2023 were listed in operation date order and operation time of each case was checked. Cusum analysis was performed on the operation time.

Results : In total 46 cases of laparoscopic donor hepatectomy, 9 cases were left and 37 cases were right graft donors. Among those right graft cases, 6 were hand assisted procedures which was performed in the very early period (1st - 6th donor). There were 54 cases of laparoscopic hepatectomy before the first laparoscopic living donor hepatectomy. The learning curve for the laparoscopic living donor hepatectomy was divided in to 3 phases; phase 1 (3 initial donors), phase 2 (6 intermediate donors), and phase 3 (the subsequent donors). There was no open conversion case.

Conclusions : To perform a safe and skillful laparoscopic living liver donor hepatectomy, adequate previous laparoscopic liver resection experience may be important. Because phase 1 in the learning curve appears very short, once proficient laparoscopic hepatectomy becomes possible, laparoscopic living donor hepatectomy also rapidly reaching the learning phase.