Extended left hepatectomy: technical aspects of an evolving procedure

Lessons learned in an operative experience of 14 patients submitted to extended left hepatectomy for the management of liver tumours are presented. There were no deaths within 30 days of operation. Essential preoperative studies, indications and technical details of the operation are described. The importance of the morphology of the tumour and the influence of the tumour on the technique to be adopted are emphasized. Modifications of technique that allow selection of patients for the procedure, control of venous bleeding, accurate identification of the sectorial portal pedicles within the right liver and definition of the plane of parenchymal transection are addressed.