Resection of entire left lobe of liver: Intrahepatic abscesses, stones and foreign bodies

Abstract

1. 1. A case study is presented in which a patient underwent complete resection of the left lobe of the liver because of total obstruction of the main left hepatic bile duct, thrombosis of the left portal vein, intraductal stones and multiple abscesses of the liver. 2. 2. The portal veins, hepatic arteries and bile ducts have a segmental distribution, dividing the liver into the right and left lobes. All hepatic substance lying to the right of an imaginary line passing through the long axis of the gallbladder to the center of the inferior vena cava, where it comes in contact with the posterior surface of the liver, constitutes the right lobe. The left lobe lies to the left of this line. The right lobe is further divided into anterior and posterior segments and the left lobe into medial and lateral segments. Each lobe has its individual blood supply and ductal system, there being no cross anastomoses or collateral pathways. Injury to the larger bile ducts and blood vessels, therefore, has an adverse effect on all parenchymal tissue peripheral to the point of injury. 3. 3. Operative cholangiograms provide an excellent method for detecting the presence and location of intraductal stones, tumors, abscesses and foreign bodies. 4. 4. Radiographic scanning with rose bengal isotopes permits an accurate estimate of the amount of hepatic damage resulting from the intrahepatic disease. 5. 5. Various methods employed for resective procedures on the liver are discussed and evaluated.