Extended Left Hepatectomy

with in situ cold perfusion

An extended left hepatectomy is the surgical removal of the left half of the liver, plus portions of the right. Extended hepatectomies are complex liver resection procedures usually only done for extreme cases of aggressive liver cancers.

This case illustrates an extended left hepatectomy of segments 1, 2, 3, 4, and portions of 7 and 8, with re-implantation of the right lobe via in situ cold perfusion technique surgical procedure. The patient's case history is discussed, and the location of the tumour is shown. The plane of transection is demonstrated in relation to anatomical landmarks, and major steps of the procedure are summarized using 3D models created from 3D reconstructions of the patient's own anatomy.

Content Advisors

Ian D. McGilvray, MD, FRCSC, PhD
Founding Director TVASurg, HPB & Transplant Editor
Toronto General Hospital, UHN
Division of General Surgery, Department of Surgery,
University of Toronto

Paul D. Greig, MD, FRCSC, FACS
Founding Co-Director, HPB & Transplant Editor
Toronto General Hospital, UHN
Division of General Surgery, Department of Surgery,
University of Toronto

Narrative

A unique surgical technique was employed to lengthen the available operation time by preserving the liver tissue–in situ cold perfusion, where the liver is cooled down and flushed to prevent long-term damage.