Transverse right epigastric incision with careful hemostasis, in the midline carried to the xyphoid process; exploration of the abdominal cavity; after covering the wound edges with moist surgical towels insert the retractor system.
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Laparotomy
![Laparotomy]()
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Dividing the falciform ligament
![Dividing the falciform ligament]()
After ruling out extrahepatic metastasis divide the falciform ligament.
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Freeing the liver
![Freeing the liver]()
Divide the right triangular ligament; free the liver from its adhesions with the diaphragm and expose the hepatocaval confluence.
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Exposing the inferior vena cava
![Exposing the inferior vena cava]()
Free the liver from caudad as well; expose the posthepatic inferior vena cava and manage the contributing veins there with clips or suture-ligatures. Encircle the right hepatic vein with a vessel loop.
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Resecting the gallbladder
![Resecting the gallbladder]()
After exploration of the hepatic hilum dissect the gallbladder in antegrade fashion from its bed and resect.
Local findings
Examine the liver and verify the preoperative findings for vascular anatomy, location and size of t
Examine the liver and verify the preoperative findings for vascular anatomy, location and size of t
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TachoSil<sup>®</sup> Versiegelungsmatrix
TachoSil® wird bei Erwachsenen und Kindern ab einem Alter von 1 Monat zur unterstützenden Behandlun
TachoSil® wird bei Erwachsenen und Kindern ab einem Alter von 1 Monat zur unterstützenden Behandlun
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general and visceral surgery
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