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Open Radical Cholecystectomy with Partial Hepatectomy for Gallbladder Cancer
Tags: General Surgery
Table of Contents
- 1. Introduction
- 2. Incision and Access to the Abdominal Cavity Incision Peritoneal Washing Cytology Incision Extension Xiphoid Process Removal Round Ligament Isolation and Ligation Wound Protection and Gallbladder Exposure
- 3. Evaluation of Tumor Extent
- 4. Kocher Maneuver
- 5. Lymphadenectomy
- 6. Partial Hepatectomy (Segments IVb and V Hepatic Resection)
- 7. Closure
- 8. Post-op Remarks
1. Introduction
2. Incision and Access to the Abdominal Cavity
- Incision
- Peritoneal Washing Cytology
- Incision Extension
- Xiphoid Process Removal
- Round Ligament Isolation and Ligation
- Continue Incision Extension
- Wound Protection and Gallbladder Exposure
3. Evaluation of Tumor Extent
- Liver Ultrasonography
- Rule Out Peritoneal Carcinomatosis
4. Kocher Maneuver
5. Lymphadenectomy
- Para-Aortic Lymphadenectomy
- Level 8 Common Hepatic Artery Lymphadenectomy (Part 1)
- Level 13 Retropancreatic Lymphadenectomy
- Portal Vein Dissection
- Level 8 Common Hepatic Artery Lymphadenectomy (Part 2 - Left)
- Level 8 Common Hepatic Artery Lymphadenectomy (Part 2 - Right)
- Cystic Duct Isolation
- Cystic Duct Division
- Level 12b Hepatoduodenal Ligament (Along the Common Bile Duct) Lymphadenectomy and Common Bile Duct Dissection
- Cystic Artery Identification, Isolation, and Ligation
- Hilar Dissection
- Review of Progress and Anatomy
6. Partial Hepatectomy (Segments IVb and V Hepatic Resection)
- Right Liver Mobilization
- US-Guided Liver Resection Line Marking
- Liver Parenchyma Division
- Surgical Specimen Examination
- Hemostasis
7. Closure
- Drain 1 Placement
- Transverse Incision Closure
- Drain 2 Placement
- Midline Incision Closure
- Skin Closure