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目的:总结本中心腹腔镜活体肝移植供肝切取的临床效果和技术改进，探讨活体肝移植供者全腔镜手术的临床特点和价值。方法:回顾首都医科大学附属北京友谊医院肝移植中心2019年7月至2020年7月实施的76例全腹腔镜下活体肝移植供肝切取手术的临床资料。对76例供者及其移植物的围手术期相关数据进行分析。对吲哚菁绿荧光显像在胆道劈分以及改进后的血管切开闭合器在肝静脉离断中应用临床效果进行初步的统计和分析。结果:76例全腹腔镜活体供肝获取手术中，不包含肝中静脉的右半肝获取7例，左半肝获取12例(6例包含肝中静脉)，肝左外叶获取55例，单独肝段(Ⅱ段)获取2例。所有供者手术均未输血，1例左外叶供者术后门静脉右支血栓形成，行开腹门静脉右支(经左支残端)取栓术，术后顺利恢复出院；余供者术后均无Clavien-Dino分级Ⅱ级以上并发症发生。除最初8例腹腔镜下肝左外叶切取术中未施行胆道造影外，其余68例腹腔镜供者手术均采用ICG荧光显像实时引导下离断胆道。69例供者手术(左肝及右肝移植物)采用改进的直线型血管闭合器(one-side stapler)离断肝静脉，仅3例需进行流出道的补片延长性重建。结论:具备丰富的活体肝移植供者开腹获取手术和一定的腹腔镜肝脏手术经验是开展腹腔镜活体供肝获取手术的基础。对于腔镜下的胆道和肝静脉的离断，采用新的方法和器械有助于保障临床效果的同时提高手术操作的便捷性。“,”Objective:To summarize the clinical efficacies and technical refinements of laparoscopic living donor liver transplantation (LDLT) and explore the clinical characteristics and value of pure laparoscopy for LDLT donors.Methods:From July 2019 to July 2020, retrospectively analyses were performed for clinical data of 76 cases of laparoscopic hepatectomy of living donor. The perioperative data of 76 donors and grafts were analyzed. And initial review was performed for clinical results on both real-time indocyanine green (ICG) fluorescent cholangiography during biliary splitting and modified unilateral stapler during hepatic vein dividing.Results:The grafts of living donor were right livers without middle hepatic vein (n=7), left liver (n=12) (6 cases of middle liver vein), left lateral lobe (n=55) and monosegments (Ⅱ, n=2). No transfusion was required during donor operations. No donor had any postoperative complication of Clavien-Dino classification II or more. Only 1 case of left lateral hepatectomy developed acute postoperative thrombosis in right portal vein. Thrombectomy was performed successfully and all donors were discharged uneventfully. Intraoperative cholangiography was not adopted during the first 8 cases of laparoscopic left lateral hepatectomy. Real-time ICG fluorescent cholangiography was employed for determining the bifurcation of hepatic duct in the following 68 cases. Unilateral stapler was employed for transecting hepatic vein during69 donor operations including right and left grafts with only 3cases of reconstruction for hepatic vein.Conclusions:Laparoscopic liver graft harvesting in living donor is achieved with rich experiences during open hepatectomy of living donor and some skills during laparoscopic hepatectomy. For dividing of biliary and hepatic vein during laparoscopic hepatectomy of living donor, applications of new methods and instruments ensure the clinical efficacies and improve surgical convenience.