Major hepatic resections for various causes are being done with increasing frequency.2,3,6,9 A low operative mortality rate comparable with that for other major intra-abdominal operations can be obtained if careful attention is paid to a few technical and anatomical details. A modified guillotine technique has practical advantages over the controlled technique of Lortat-Jacob.6
Indications for Right Hepatic Lobectomy
Benign.
—(1) Massive hemangioma, hamartoma, fibroma, etc.; (2) cysts—simple and ecchinococcus; (3) abscess—large single or multiple; (4) trauma—multiple fractures, gunshot wounds, etc.
Malignant.
—(1) Primary liver-cell carcinoma, cholangiocarcinoma, and sarcoma; (2) metastatic—carcinoma of the gallbladder, some slow-growing tumors such as of colon, etc.In the treatment of benign conditions, one should conserve as much liver tissue as possible. This can be accomplished by guillotine excision in various planes, by enucleation, or by wedge resection.The role of excisional surgery in cases of traumatized liver is analogous to that of the