Principles of Hepatic Surgery

Right Liver Resections

Author(s): Takuya Hashimoto and Masatoshi Makuuchi

Pp: 428-437 (10)

DOI: 10.2174/9781681082851116010029

* (Excluding Mailing and Handling)

Abstract

• Anatomical right liver resections include right hepatectomy (segments 5 to 8),right lobectomy (segments 4 to 8), right paramedian setorectomy (segments 5and 8), and right lateral sectorectomy (segments 6 and 7).

• Anatomical segment-oriented liver resections require accurate knowledge of landmarks and precise dissection of the hilar region. Appropriate surgical view, occasionally requiring associated laparotomy and thoracotomy, is crucial for a safe resection.

• Right liver mobilization (before or after parenchymal transection) is usually needed, and complete mobilization from the inferior vena cava is required if liver resection includes segment 1.

• After right hepatectomy or right lobectomy, fixation of the falciform ligament keeps the remnant liver in anatomical position and allows adequate outflow.

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