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Updated: Sep 2, 2026

Right Hemihepatectomy by Suprahilar Intrahepatic Transection of the Right Hemipedicle using a Vascular Stapler
Published on: January 25, 2010
Biliary stricture due to hypertrophied liver rotation after right hepatic lobectomy
Background:
After partial hepatectomy, liver regeneration occurs with the hepatocyte mass to its almost previous size. Biliary stricture due to hypertrophied liver rotation following partial hepatectomy is uncommon and its management still remains controversial. We encountered extrahepatic biliary stricture due to hypertrophied left lobe rotation in 2 patients who had right hepatic lobectomy for liver trauma. Herein, we present our experience with the modified Longmire procedure for the management of this complication.
Results:
There were no complications during the early postoperative period in either of the patients. After the Longmire procedure, the first patient was followed for 5 months with some elevation in liver enzymes and the other was followed for 14 months with normal liver function tests. Both of the patients are completely symptom free postoperatively.
Conclusion:
The present experience suggests that the modified Longmire procedure is the most promising surgical approach to the management of biliary stricture due to hypertrophied left lobe rotation after right hepatic lobectomy.

