Patient volunteered to be a living liver donor for his brother, who suffered from end-stage liver disease for alcoholic cirrhosis.
The size of the graft and the residual liver volume was carefully calculated before the operation.
The planned transection plane starts from the gallbladder fossa, and extends to the posterior groove between the right and middle hepatic veins.
The gallbladder is taken in a retrograde fashion, with its proximal end tied and cut. A catheter will then be placed in Hartman's Pouch, to facilitate an intra-operative cholangiogram.
During the portal dissection, a clip will be placed in the nearby tissue of the left hepatic duct.
Along with the intra-operative cholangiogram, the clip will indicate an area of the left hepatic duct which is located away from the hepatic duct bifurcation, and the bifurcation of the segments II/III and segment IV branches.
The left hepatic artery will be divided at the common trunk below the bifurcation of the segments II/III and segment IV branches.
The left portal vein will be stapled with an endo-TA stapler, and divided on the graft side of the staples.
The middle/left hepatic veins will be divided in a similar manner.