A Simplified Technique for Hepatectomy.

Abstract

For the past year there has been employed in this laboratory a simplified method for hepatectomy. The technique used is an extension of Mann's method for abdominal evisceration, 1 and is briefly as follows: Through a mid-line incision the inferior vena cava proximal to the lumbo-adrenal vein is loosely ligated with stout linen so that about 4/5 of its lumen is occluded. The portal vein, at its point of bifurcation in the portal fissure, is similarly ligated proximal to its last tributary. The intestine should be mildly congested but not cyanosed, and the ligature only rarely requires to be slightly loosened.

The dogs uniformly make an excellent recovery. The liver is removed at a second operation, which is best done six or more weeks later. The structures in the lesser omentum are tied and cut, as is also the vena cava below and above the liver. The intestines do not become cyanosed.

The animal makes an excellent recovery, and walks normally. We have evidence that the venous return from the posterior half of the body is not impaired. The subsequent fate of the animal is the same as that following hepatectomy by Mann's three-stage operation. 2

This is a preliminary report.