How to Prevent Pitfalls

Feasibility and safety of the Glissonean approach have been widely described in literature. The focus of the present chapter is 'how to prevent pitfalls' of the technique and eventually reduce failure rate. The first and most important cause of procedure failure is represented by anatomical variations, especially portal vein bifurcation that are associated with inadequate pedicle clamping. The anatomical variants can also involve the arterial and biliary structures with a consequent risk of biliary leakage or bleeding. Anatomical abnormalities alone do not represent a formal contraindication to technique application, however preoperative misknowledge of such variations could lead to inadequate intraoperative management, and subsequently failure or complication. In the following chapter, all these technical points will be discussed in detail.