The hepatoduodenal ligament is taped and pulled up perpendicularly, exposing several small branches nourishing the caudate area behind the right and left primary branches. The right primary branch of the Glissonean pedicle is detached from the hepatic hilum (Fig. 6.6). Pull this branch upward and detach the surrounding liver parenchyma. There are some short Glissonean
pedicles ramifying from the right primary branch. These are each transected, one by one. After the caudate process area is resected, the right inferior hepatic vein is exposed at the cut surface between the right segment and the caudate area (Fig. 6.7). Total caudate area resection is done after several thin Glissonean pedicles branching from the right and left primary branches have been transected (Fig. 6.8).
The border of the parenchyma between the right segment and the caudate area is dissected on the lateral triangle (Fig. 6.9). The border between the left segment and the caudate area is dissected on the paracaval triangle by the right lateral approach, after mobilization of the right lobe (Fig. 6.10).
The total caudate area resection is completed (Fig. 6.11). The remaining liver is connected only to the main hepatic veins.
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