Introduction : Pure laparoscopic donor hepatectomy has advantages than conventional donor hepatectomy or laparoscopy-assisted hepatectomy. But bile duct division is the most difficult thing during operation. The initial period, there was many trials to make a safe and feasible technique. We describe different methods and chronical changes of bile duct division methods in pure laparoscopic donor hepatectomy.

Methods : Between January 2016 and December 2018, we performed 92 cases of pure laparoscopic donor hepatectomy. We usually use ICG cholangiography intraoperatively for bile duct division. We divided 3 periods as the methods for bile duct division. 1) Suture 2) Metal clip 3) Hem-o Lok was used for each period.

Results : There was no bile duct complication after changing our method for bile duct division. The suture method is the same procedure with that of open donor hepatectomy. But it is time-consuming procedure than other method and sometimes it caused remnant bile duct stenosis. Metal clip is easy to apply but it can be spillages when the bile duct is thick. Hem-o-Lok can be a solution to this problem. We need to dissect more around bile duct for applying that. But there was no spillages during operation. And there was no bile leak at the remnant stump.

Conclusions : Various bile duct division technique had several merits and drawbacks. We should choose the appropriate method for safe pure laparoscopic donor hepatectomy.