Kelompok Nasi (Lab Anatomy, Senin Pagi)

- Muhammad Fachrurozi Sidiq

- Yuliatul M.
- M. Mufakkirul Islam
- Maghfira Pradipta
- Astri Keli
- Nabilla Osseva
- Adelina Siagian
- Fadla Khairatuismi

HEPATIC RESECTION

Steps of Major Hepatic Resections

1. First, we have to make the skin incision—right subcostal with or without a partial or
complete left subcostal extension across the midline, depending on the patient’s habitus
and liver/tumor anatomy.
2. Open and explore the abdomen, and place a fixed table retractor (e.g., Thompson or
Bookwalter).
3. Examine the liver with bimanual palpation. Perform liver ultrasound and confirm the
operation to be performed.
4. Take down the round and falciform ligaments, and expose the anterior surface of the
hepatic veins.
5. For a left hepatectomy, divide the left triangular ligament; for a right hepatectomy,
mobilize the right lobe from the right coronary and triangular ligaments.
6. Open the gastrohepatic ligament, palpate the porta hepatis, and assess for accessory or
replaced hepatic arteries.
7. Perform a cholecystectomy; leave the gallbladder with the cystic duct intact if the
gallbladder is involved by the tumor.

(Source : Schwartz Principle of Surgery, 10th Ed)