Controlling the right hepatic artery, portal vein, and hepatic vein isolates the portion of liver being removed and helps limit blood loss during transection. This control also supports orderly division along the main anatomical plane. Careful management of these structures is therefore central to maintaining the left lobe’s blood supply while reducing operative risk.
Bile ducts and vessels require careful identification and division because inadequate management can contribute to bile leakage or bleeding. These risks arise while the liver is divided along its main anatomical plane. Attention to both systems helps protect the preserved liver and improves control of complications associated with the resection.
Tumor extent determines whether the planned resection can achieve adequate oncologic clearance while leaving a suitable portion of liver behind. Assessment considers the distribution of disease within the right lobe and its relationship to vessels and bile ducts. This planning helps align the surgical boundary with tumor control and preservation of the left lobe.
Safety planning includes evaluation of liver function, remnant volume, vascular anatomy, and tumor extent. Liver function indicates how well the remaining tissue may perform, while remnant volume estimates how much liver will remain after resection. Vascular mapping and tumor assessment further support an operative plan that balances adequate clearance with preservation of the left lobe.
The procedure requires control of the right hepatic artery, portal vein, and hepatic vein, followed by division of the liver along the main anatomical plane. The surgeon must also manage bile ducts and vessels carefully during transection. Together, these steps separate the diseased portion, preserve the left-sided blood supply, and help limit bleeding and bile leakage.
This major resection is considered for selected primary liver tumors, metastatic liver tumors, and, in some settings, other localized hepatic disease. Its use depends on tumor extent, liver function, vascular anatomy, and the expected remnant volume. The intended outcome is removal of localized disease with sufficient oncologic clearance while retaining an adequate functional liver remnant.