Hepatic Wedge Resection

Abstract

Indication • Peripheral, small, primary, or metastatic tumors Essential Steps 1. Right subcostal incision/midline laparotomy. 2. Explore the abdomen and assess for metastasis. 3. Mobilize the liver by dividing its ligamentous attachments. 4. Establish margins of resection around the lesion by cauterizing Glisson's capsule. 5. Transect the parenchyma using cautery, finger fracture, or other device of choice. 6. Obtain hemostasis and bile stasis by clipping or ligating vessels and bile ducts >2 mm encountered. 7. Irrigate. 8. Place drain (optional). 9. Close the abdomen. Note These Variations • Method of parenchymal transection • Use of drain Complications • Recurrence • Bile leak • Bleeding Template Operative Dictation Preoperative Diagnosis Primary/metastatic ____ cancer involving segment ___ of the liver Procedure Wedge resection of segment ____ of the liver Postoperative Diagnosis Same Indications This is a ___-year-old male/female who is known to have a peripheral lesion in segment ____ of the liver requiring resection. Wedge resection was indicated. Description of Procedure An epidural cath­ eter was placed prior to the start of the opera­ tion. The patient was brought into the operating room and placed on the table in the supine