- The patient was a 65 year old man with multiple colorectal metastatic lesions in almost every segment of his liver.
- The largest lesion was visible on the surface of segments V & VI, and a signficant lesion in the caudate lobe was beginning to invade the vena cava.
- An extended right hepatectomy, resection of segments I, V, VI, & VII, with preservation of segment 8 and multiple wedge resections was deemed the best option to leave adequate post-operative liver volume.
- Multiple segment V portal veins will be divided during transection.
- The RHV will be ligated and divided, and the Spigelian vein (largest of the caudate draining veins) will be resected with a cuff of vena cava at the end of parenchymal transection.
- Wedge resections removed lesions close to the liver surface in segments II, III, IVa & IVb.
CT scans (venous phase)
CT scans (arterial phase)