After transection of the right hepatic duct, tissue from both the left and right ductal margins is sent for frozen section analysis. The entire gallbladder bed including segments 4b and 5 is then resected along the dotted lines shown. The portal veins and hepatic arteries are protected under direct vision. Liver parenchymal transaction is as described in Sect. 3, chapters "Liver Resections" and "Left Hemihepatectomy," usually with inflow occlusion by the Pringle maneuver, and with central venous pressure (CVP) maintained below 3 cm H2O (see Sect. 3, chapter "Extended Hemihepatectomies").
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