Bisegment

If the Arches BI and IK be cut in the middle in a, and b, likewiſe the Arches DM, ML being cut in the middle in c and d; and the Chords of the Bifegments in the Arch BK being drawn; likewiſe the Chords of the Biſegments in the Arch DL; alſo theſe will be as AB to AD, and they will always be ſo, if the Biſegments of the Bifegments proceed infinitely. Alſo the fame is true in the Biſections of the Arches KC and LE. But the Chords of the Biſegments infinite in number are equal to the Arch itſelf. For if all the Chords were leſs than all their Arches, there might yet a Biſection proceed; which is contrary to the ſuppoſition.

The initial experience with ALPPS [associating liver partition and portal vein ligation for staged hepatectomy] reported by Schnitzbauer et al. demonstrated a higher FLR regeneration rate of 74% after first stage, compared with that after right portal vein embolization (PVE) or portal vein ligation (PVL) (40%-69%) (Table 2). Although previously reported regeneration rates after PVE or PVL appear lower than those after the first stage in ALPPS strategy, we should point out a major issue that right PVE without segment 4 embolization prior to extended right hepatectomy leads to the undesirable segment 4 regeneration at the expense of lesser regeneration of the left lateral bisegments. However, right PVE with segment 4 embolization is associated with a significant increase in hypertrophy of the left lateral bisegments, compared to right PVE without segment 4 embolization (right with segment 4 vs right without segment 4, 26% vs 54% in regeneration rate).