Abdominal cross-sectional imaging of the associating liver partition and portal vein ligation for staged hepatectomy procedure

Figure 3 Radiologists should carefully report the number, size, and location of individual lesions, as well as their relationship with surgically relevant anatomic structures, including the hepatic artery, main portal branches, hepatic veins, and first- to second-order biliary branches. A: Preoperative assessment with computed tomography in a 64 male years old patient showing colorectal metastases on the right hepatic lobe (red arrow). Right trisectionectomy associating liver partition and portal vein ligation for staged hepatectomy was planned; B: One small satellite lesion was found on the left side of the middle hepatic vein (arrowhead), indicating the need for future liver remnant clean-up during stage 1; C: No vascular involvement was shown, as exemplified by patent main portal trunk and intrahepatic branches (green triangle), except for infiltration of the middle hepatic vein (double green triangle). Based on this finding, a wide free margin between the line of resection and the middle hepatic vein was obtained.