Case Description

• A 41 year old female patient was found with metastatic colon cancer. Previous wedge resections has left her with a relatively small left lobe liver.
• Tumor was found lodged between right and middle hepatic veins, located within the segment VIII liver.
• The liver will be split from the L/MHV groove to the gallbladder fossa, allowing maximum mobility of the left and right lobes from the vena cava.
• For additional mobility, the caudate lobe is resected from the left lobe liver.
• Segment VIII is resected; the right and middle hepatic veins will remain intact in the liver until cold perfusion is set up.
• With the liver under in situ cold perfusion, the right and middle hepatic veins are divided at their origins and within the liver.
• The remnant liver is mobilized medially towards the vena cava, and the right/middle hepatic veins are reconstructed to their origins.