Laparoscopic approach was rarely described in recipients for liver transplantation (LT). We report the feasibility and safety of laparoscopic-assisted LT (LA-LT) in patients with unresectable liver metastases of neuroendocrine tumors. Total hepatectomy was performed laparoscopically with graft implantation through an upper midline incision. Liver grafts were retrieved from deceased donors. From July 2019 to July 2021, six patients (4 women, 2 men) underwent LA-LT. Median age and BMI were 46 (29–54) and 24 (19–35) kg/m², respectively. Implanted grafts were reduced (n = 3), full (n = 2), and a right split liver (n = 1). Median surgical time was 405 min (390–450) and median blood loss was 425 ml (250–600). Median cold and warm ischemia times were 438 min (360–575) and 35 min (30–40), respectively. Median anhepatic phase was 51 min (40–67) and midline incision was 14 cm (13–20) long. On postoperative day 5, median prothrombin index and serum bilirubin levels were 95% (70–117) and 11 (10–37) μmol/L, respectively. No Clavien-Dindo > III complications were encountered. Median hospital stay was 12 days (10–14). After a median follow-up of 8 (8–32) months, all patients were alive without tumor recurrence or adverse event. This preliminary series suggests that in selected patients, LA-LT is a safe and effective option.

中文翻译：

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腹腔镜辅助肝移植：一个现实的观点

在接受肝移植 (LT) 的患者中很少描述腹腔镜方法。我们报告了腹腔镜辅助 LT (LA-LT) 在无法切除的神经内分泌肿瘤肝转移患者中的可行性和安全性。全肝切除术是通过腹腔镜通过上中线切口进行移植物植入。肝移植物取自已故捐献者。从 2019 年 7 月到 2021 年 7 月，6 名患者（4 名女性，2 名男性）接受了 LA-LT。中位年龄和 BMI 分别为 46 (29–54) 和 24 (19–35) kg/m ²。植入的移植物减少（n  = 3），完整（n  = 2）和右分裂肝（n = 1). 中位手术时间为 405 分钟 (390-450)，中位失血量为 425 毫升 (250-600)。中位冷和热缺血时间分别为 438 分钟 (360–575) 和 35 分钟 (30–40)。中位无肝期为 51 分钟 (40-67)，中线切口长 14 厘米 (13-20)。术后第 5 天，中位凝血酶原指数和血清胆红素水平分别为 95% (70–117) 和 11 (10–37) μmol/L。没有遇到 Clavien-Dindo > III 并发症。中位住院时间为 12 天 (10–14)。中位随访 8 (8–32) 个月后，所有患者均存活，无肿瘤复发或不良事件。该初步系列表明，在选定的患者中，LA-LT 是一种安全有效的选择。