Standard Open Right Hepatectomy

Abstract

The evolution of hepatic resection from an imprecise removal of portions of the liver often associated with a mortality rate of up to 20% to a routine and controlled anatomic procedure with operative risk less than 5%, represents a major advance in modern surgery. This accomplishment has been made thanks to better understanding of the liver vascular and biliary anatomy, recognition of the functional reserve of the liver and the potential for regeneration, advances is surgical technique as well as anesthesia and perioperative care. These factors, along with the improvement of prolonged survival following hepatic resection for colorectal metastases, hepatocel-lular and cholangiocarcinoma have led to an expansion of liver surgery. In this chapter, we will give the evolution of the technique used for the standard open right hepatectomy. In addition, we will describe on detail our technique employed for right hepatectomy focusing on indications, preoperative preparation and specific technical aspects.