Dissection of the Liver Parenchyma

This procedure is usually done by the anterior approach. The liver is dissected just up to the IVC. In this operation, both the right and middle hepatic veins and several short hepatic veins are dissected at inside the liver. Figure 5.58 shows completion of right trisegmentectomy.

Fig. 5.58. Completion of right trisegmentectomy

6 Resection of the Caudate Area (i.e., Spiegel Area and Caudate Process) (See DVD 2)

Several thin feeders of the caudate area ramify from the right and left primary branches. The caudate area is bound to all three segments and encloses the IVC. Some short hepatic veins flow into the IVC (Figs. 6.1, 6.2).

Fig. 6.1. Schema of resection of caudate area. Glissonean branch to the caudate area is ramified from main trunk and both primary branches of Glissonean pedicle outside the liver

Caudate area

Fig. 6.2. Schema of resection of caudate area, showing some short hepatic veins must be cut

Caudate area

Fig. 6.2. Schema of resection of caudate area, showing some short hepatic veins must be cut

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