Right hemihepatectomy

Anatomy Perioperative management Technique Complications Evidence Total Video Medical Equipment

Content

Laparotomy
Transection of the falciform ligament of the liver
Mobilization of the Liver
Preparation of the Inferior Vena Cava
Mobilization of the Gallbladder
Local Exploration
Preparation of the Hepatoduodenal Ligament
Lymphadenectomy
Vascular ligation
Ischemic Demarcation
Parenchymal transection
Transection of the right hepatic vein
Division of the right bile duct
Exclusion of bile leaks, removal of the gallbladder
Check for Hemostasis
Sealing and Drainage
Refixation of the ligamentum teres hepatis
Abdominal wall closure

Authors

Date

date of publication: 25.04.2009
date of update: 20.08.2022

surgery report

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Laparotomy

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Laparotomy via upper abdominal right-angle incision with meticulous hemostasis; transverse in the right upper abdomen, median cranially to the xiphoid; Exploration of the abdomen, folding back of the wound edges and insertion of the retraction device.
Transection of the falciform ligament of the liver

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After exclusion of extrahepatic metastases, transection of the falciform ligament of the liver.
Mobilization of the Liver

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Division of the right triangular ligament; Mobilization of the liver from the adhesions to the diaphragm with exposure of the venous star
Preparation of the Inferior Vena Cava

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Mobilization of the liver also from caudal; the retrohepatic inferior vena cava is prepared and the veins draining into it are secured by clips or ligations; Looping of the right hepatic vein.
Mobilization of the Gallbladder

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After exploration of the hepatic hilum, the anterograde mobilization of the gallbladder is performed.