Selection of four surgical techniques in orthotopic liver transplantation

Objective: To compare the advantages and disadvantages of four surgical techniques in orthotopic liver transplantation. Methods: A total of 135 adult recipients receiving cadaveric whole liver grafts were dividied into four groups according to the surgeries they received: group A (n=22) underwent classic orthotopic liver transplantation, group B (n = 79) underwent modified piggyback liver transplantation, group C (n = 18) underwent classical piggyback liver transplantation, and group D (n = 16) underwent modified classic orthotopic liver transplantation. The clinical data of these recipients were retrospectively analyzed. Results: The operation time, anhepatic time, and intra-operation bleeding volume among these four groups were significantly different (P < 0.05). The incidence of transient renal damage in group C was significantly lower than that in other groups (P < 0.05), while the complication rates and survival rates were not significantly different in the early stage after the operation. Conclusions: Surgery techniques should be carefully selected based on the individual patients's pre-operative condition. The modified classic orthotopic liver transplantation is a preferred technique for tumor patients or patients with surgical history of upper abdomen.