A simplified method for controlled left hepatectomy

Abstract

Left hepatectomy consists of the removal of the area supplied by the left portal pedicle, separated from the right lobe of the liver by the main portal fissure running from the middle of the gallbladder bed to the left anterior surface of the inferior vena cava; removal of the caudate lobe is optional. During the first step in conventional hepatectomy, the elements of the left portal pedicle are usually dissected in the hilum, and many surgeons remove the gallbladder. The procedure is not always easy to perform and death and morbidity are not negligible. A recent case gave me the opportunity to elaborate on a simple technique: ligation without interruption of the left pedicle in the left end of the hilum, providing immediate hemostasis of the left liver and making resection as easy as that for a cholecystectomy or hysterectomy.