2009 Program and Abstracts: Management of Anatomic Hilar Variations During Laparoscopic Right Hepatectomy
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Management of Anatomic Hilar Variations During Laparoscopic Right Hepatectomy
Aziz M. Merchant, Edward Lin, Juan M. Sarmiento*
Surgery, Emory University Hospital, Atlanta, GA
We present 3 scenarios of hilar dissection: 1-Portal vein (PV) trifurcation and lowering of the hilar plate. The hilar plate is lowered on the right and left side to take the right hepatic artery and then the right naterior and posterior PV separately.2-High bifurcation of the PV and lateral transection of the cystic plate. The anterior and posterior branches of the right hepatic artery are taken separately. By transecting the gallbladder plate, there is access to the PV bifurcation. 3-Continuation of the hilum into the Incissura Dextrus of Gans. The Incissura is visible in the hilum in the right lobe without liver parenchyma interposition and is easily identified and dissected.
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