Pure laparoscopic living donor right hemihepatectomy (PLDRH) has been performed in many experienced centers. However, portal vein variations still remain challenging thus disturbing the widespread of PLDRH in many centers. PLDRH when integrated with 3-dimensional laparoscopy and indocyanine green (ICG) near-infrared fluorescence cholangiography is safe and feasible. Methods

We reviewed 19 donors with separated right anterior and right posterior portal veins who underwent living donor right hemihepatectomy between January 2014 and December 2016. We compared the clinical outcomes of PLDRH and conventional open right hemihepatectomy (CDRH). Results

6 donors (31.6%) underwent PLDRH while 13 donors (68.4%) underwent CDRH. There was no intraoperative complications, transfusions and open conversions in the PLDRH donors. The total operative time was longer in PLDRH (356.5 vs. 244.5 minutes, p =0.003). However, the length of hospital stay (8.5 vs. 9.0 days, p =0.703), blood loss (450.0 vs. 393.6 ml, p =0.557) and complication rate (16.6% vs.27.3%; p =0.327) did not differ between the two groups. Conclusions

PLDRH is safe and feasible in donors with type II and III portal vein variations. Further prospective comparative studies are needed to prove the safety and efficacy of PLDRH.