Types of Segment-Oriented Hepatic Resection by the Glissonean Pedicle Approach

  • Jixiong HuEmail author
  • Weidong Dai
  • Zhongkun Zuo
  • Chun Liu


Among liver resections, right hepatectomy (RH) was defined as a major hepatectomy [1]. According to the Brisbane classification, a right hepatectomy was described as resection of the Couinaud’s segments V–VIII (± segment I) [2]. Patients who required ligation of the middle hepatic vein were included only if the hepatic parenchymal transection plane containing this vein and segment IV was preserved. The volume of the right hemiliver was about 60–65% of the whole liver [3, 4]. In terms of liver function evaluation, Makuuchi criteria [5], including preoperative serum total bilirubin level, Child-Pugh classification, and the indocyanine green retention rate at 15 min (ICGR15) were used to determine the extent of safe liver resection. Right hepatectomy was indicated only for patients with Child-Pugh class A, serum total bilirubin level less than 1.0 mg/dl, and the ICGR15 less than 10%. For huge tumor confined to the right hemiliver, if the volume of the functional liver parenchymal within the right liver to be sacrificed is small, and/or the volume of the left liver is increased because of the contralateral portal vein tumor embolism, right hepatectomy can be performed even if the ICGR15 is more than 10% [3]. The patients with Child-Pugh class B and C liver function, hyperbilirubinemia, encephalopathy, hypoalbuminemia, and ascites were excluded from this procedure.


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Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Jixiong Hu
    • 1
    Email author
  • Weidong Dai
    • 1
  • Zhongkun Zuo
    • 2
  • Chun Liu
    • 1
  1. 1.Department of Hepatobiliary Surgery and Hunan Provincial Key Laboratory of Hepatobiliary Disease ResearchThe Second Xiangya Hospital, Central South UniversityChangshaPR China
  2. 2.Department of Minimally Invasive SurgeryThe Second Xiangya Hospital, Central South UniversityChangshaChina

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