ROBOTIC ANATOMICAL RIGHT HEPATECTOMY FOR NECROTIC CHOLANGIOCARCINOMA TECHNIQUE OF INFLOW CONTROL IN NAKAMURA TYPE B PORTAL VEIN ANATOMY

Anatomical variations in the inflow vasculatures must be anticipated in any anatomical hepatectomy to avoid complications. Nakamura Type B portal vein (PV) anatomy requires individual isolation of right anterior and posterior PV to avoid narrowing of the left PV. In this video, we describe a safe technique of robotic anatomical right hepatectomy in a 60-year-old woman with a 4cm cholangiocarcinoma wedged between the right anterior and posterior Glissonean pedicle. After individual ligations of the inflow structures, the liver parenchyma was divided in a hemostatic fashion. The operation was uneventful. Final pathology showed necrotic cholangiocarcinoma. Future liver remnant is well-perfused.