TOTAL RIGHT hepatic lobectomy has been successfully performed by us in the management of primary liver tumors, of metastatic cancers in the right lobe, and of gall bladder cancers. The surgical technique has been standardized, and the operation can now be performed with relative safety. The epiphenomena of total right hepatic lobectomy—including the metabolic changes caused by removal of 80% of the liver substance and the factors contributing to rapid and complete regenerative hyperplasia in the residual left lobe—have been studied in rats, dogs, and humans. It is our belief that the operation will find general acceptance and common employment now that these facts are known.
The liver contains a large mesodermal component in its somatic framework. One patient originally thought to have a massive granuloma of the right hepatic lobe lived almost three years after right lobectomy before dying of metastases; subsequent study led to a review