Separation of the Glissonean Pedicles Fig 554ab

The tertiary branches of the left medial area are transected first. All these tertiary branches come directly from the right side of the left segmental branch of the Glissonean pedicle. Each of these branches must be cut at its base. Dissection of the liver is done on the line between the lateral and medial areas and also on the paracaval triangle (Fig. 5.55).

Fig. 5.54a. Separation of the Glissonean pedicles. Transection of several numbers of tertiary branches ramified from left segmental pedicle a

Fig. 5.54a. Separation of the Glissonean pedicles. Transection of several numbers of tertiary branches ramified from left segmental pedicle

Fig. 5.54b. Liver dissection is done on the demarcated line to the imaginary line A-B

Fig. 5.55. Dissection of the liver along the anterior paracaval triangle

After dissection of the liver, the hepatic hilum is open. After that, the middle and right segmental branches of the Glissonean pedicles are easily ligated and cut (Fig. 5.56).

By these procedures, the part of the liver to be resected is freed from the Glissonean pedicle (Fig. 5.57a,b).

Fig. 5.56. After dissection of the liver on the planes between left lateral area and intersegmental plane between caudate area, middle and right segmental pedicles are transected

Fig. 5.57a. Dissection of the liver is continued after a cut of middle hepatic vein toward the IVC and origin of the right hepatic vein

Fig. 5.57a. Dissection of the liver is continued after a cut of middle hepatic vein toward the IVC and origin of the right hepatic vein

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