Careful attention must be paid to how the left hepatic vein merges with the IVC. This occurs in two ways. In one, the left hepatic vein enters the IVC directly. In the other, the left hepatic vein merges with the middle hepatic vein, which flows into the IVC. In the former case, the left hepatic vein is cut at the point of entrance into the IVC, and this is rather easy. In the latter case, however, careful attention must be paid not to cut the left hepatic vein at the entrance of the common vessels, but to cut it exactly at the merging point, so as not to allow narrowing.
Figure 7.26 shows the completed left lateral area resection. There are some cut stumps of tertiary branches at the umbilical portion of the left segmental branch. The small omentum remains intact.
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