METHOD OF PARENCHYMA-PRESERVING LEFT-SIDED HEMIHEPATECTOMY

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to surgical hepatology. A middle hepatic artery is identified. If the hepatic artery divides into the right and left hepatic arteries, the left hepatic artery divides into a middle hepatic artery and an artery dividing liver into 2, 3 segments. Thereafter, the left hepatic artery is transected in the distal direction from the middle hepatic artery. If the middle hepatic artery deviates from the right or proper hepatic arteries, the middle hepatic artery is preserved by crossing the left hepatic artery. A left portal vein is separated, intersected and sutured. Left hepatic vein is separated and transected. Further, if technically feasible, a segment of an average hepatic vein 4–5 cm long from its mouth is preserved by ligating this vein at the specified distance. A liver separation boundary is formed along a middle hepatic vein 5 mm to the left of it, then along a line between IVa and IVb segments, with further displacement to the left along the diagonal, reaching a round ligament of the liver, and further along the line with preservation of parenchyma IVb segment.;EFFECT: method enables increasing the volume of the remaining portion of liver parenchyma, reducing the risk of developing post-excreting liver failure accompanying left-sided hemihepatectomy, providing an outlet of venous blood from this segment of the liver, minimizing the risk of the edema of the segment and the dysfunction of its parenchyma.;3 cl, 1 dwg, 1 ex