Hepatic surgery.

L. H. Blumgart, C. B. Wood


The ability of the human liver to undergo regenerative hyperplasia after resection has been recognised for many centuries and reference is found to it in ancient mythology. It is this amazing potential for the regrowth that allows resection of large portions of liver substance. In recent years, detailed anatomical studies have defined the segments and lobes of the liver and provide the Surgeon with the necessary planes of dissection. There are 3 main indications for hepatic resection surgery, namely trauma, primary and secondary liver tumours and high bile duct obstruction. The indications for hepatic resection in trauma are well defined whereas there is still much debate as to the value of surgical removal of liver tumors. The role of liver resection in benign biliary obstruction is still evolving. Indications for surgery in each of these areas, along with an outline of the surgical anatomy, pre-operative assessment and operative technique form a basis for this chapter.

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