Left hepatectomy * Inflow control The hilar plate is lowered. The left hepatic artery is ligated and divided. Any accessory or replaced hepatic artery arising from the left gastric artery is similarly ligated. Dissection at the base of the umbilical…
Right hepatectomy * Laparoscopic hepatectomy The indications for hepatectomy are the same whether done by open or laparoscopic technique. It should be emphasized that laparoscopic hepatectomy is a complex procedure and requires expertise both in laparoscopic techniques and open liver…
Right hepatectomy * Inflow and biliary control The hilar plate is opened to expose the left hepatic duct and the confluence of the bile ducts. The cystic duct and the cystic artery are exposed, ligated, and divided ( Fig. 3.1…
Introduction Partial hepatectomy is possible because liver regeneration is rapid (Plate 1) and because the liver is segmental in structure (Plate 2) . Hepatic resection for removal of lesions of the liver may be necessary for a wide variety of…
Liver Gross anatomy The liver lies under the cover of the lower ribs, applied to the undersurface of the diaphragm, and is astride the inferior vena cava (IVC) posteriorly. Most of the bulk of the liver lies to the right,…
The advent and refinement of minimally invasive surgery (MIS) techniques within the realm of oncologic hepatobiliary surgery (see Chapter 127 ) has paved the way for the collateral development of this field in living donor liver transplantation (LDLT) (see Chapter…
Introduction Hepatic arterial infusion was described nearly six decades ago as a regional treatment of hepatic tumors (see Chapters 50 , 90 , and 97 ). Robotic-assisted approaches to placement of hepatic arterial infusion pumps have become more prevalent following…
The increasing use of laparoscopic procedures has been driven by the ability to perform surgery through small rather than large incisions, with reduced postoperative pain and enhanced recovery. This began with laparoscopic cholecystectomy (see Chapter 36 ) introduced in 1988…
Introduction When hepatobiliary surgeons consider what treatment is best for a patient with a tumor in the liver, several questions must be answered. What kind of tumor is it, which resection margin is necessary, is the liver sick or healthy,…
Introduction Since its initial description by Codevilla in 1898, through the first procedure performed by Kauch in 1909 and the two-stage procedure described by Whipple in 1935, the pancreaticoduodenectomy (PD) technique has evolved significantly over the last decades to become…