This paper deals with the utilization of the left main hepatic trunk in secondary repair of the bile ducts which was described by the author 28 years ago following the anatomic works of Couinaud. The reasons for choosing this duct are discussed: usual anatomic integrity, extraphepatic disposition of the trunk, and ease of location by intraoperative cholangiogram (which is considered indispensable by the author). The technical details of the operation are given: subcostal S‐shaped incision, lowering of the left trunk after a transverse incision of Glisson's capsule, opening of the trunk, instrumental exploration in the search for intrahepatic stones, and Roux‐en‐Y hepaticojejunostomy usually without a transanastomotic stent. Precise technical modifications are given for involvement of the bifurcation or morphological variations of the liver .
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J Hepp (1985) studied this question.