Introduction : Because biliary complications in living donor liver transplantation are most common and troubled problem to recipients and transplant surgeons, various methods to decrease biliary complications have been studied and determining the optimal bile duct division point is important to decrease complication. Recently, indocyanine green (ICG) near-infrared fluorescence cholangiography has been applied in laparoscopic donor hepatectomy. Because of its advantages in laparoscopic surgery, conventional cholangiography replaced by ICG fluorescence cholangiography in some institutions which have laparoscopic donor hepatectomy cases. We compared conventional cholangiography and ICG fluorescence cholangiography in determining optimal bile duct division point in pure laparoscopic donor hepatectomy.

Methods : From May 2016 to October 2019, 80 cases of pure laparoscopic donor hepatectomy has been performed by a single surgeon in Kyungpook national university hospital. Conventional cholangiography was used in 45 cases, ICG fluorescence cholangiography was used in 35 cases. We compared the outcomes of two groups in preoperative bile duct anomaly of donor, operative time and postoperative complications

Results : In bile duct anomaly of donors, there were no differences between two groups because donor selection criteria was same. Operative time was much longer in conventional cholangiography group because the procedure itself was time consuming. In conventional cholangiography group, 1 case biliary complication occurred. Bile leakage from the cutting edge of the remnant right hepatic duct was identified, resolved by ERCP and ERBD insertion.

Conclusions : ICG fluorescence cholangiography is more easier and convenient method than conventional cholangiography to perform bile duct division and dissection and is helpful to determine optimal bile division point.