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Description

Jarnagin et al classified hepatic resections based on extent and concurrent procedures. The risk of an hepatic resection increases along with its complexity. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.


 

Total number of segments: 10 (sum of right, left and central areas)

 

Anatomic Location

Number of Segments

right lobectomy (hepatectomy)

4

left lobectomy (hepatectomy)

3

central hepatectomy

3

simple enucleation

0

wedge resection

1

left lateral segmentectomy

2

right anterior sectorectomy

2

right posterior sectorectomy

2

segmental resection

sublobar, 1 or more segments

bilobar resection

resection of segments from left and right lobes

extended hepatectomy

5

 

Extrahepatic procedures making a hepatic resection "complex" if performed concurrently:

(1) organ resection

(2) biliary resection and/or reconstruction

(3) bile duct exploration

(4) portal vein resection and/or reconstruction

(5) inferior vena cava resection and/or reconstruction

(6) porta hepatis lymphadenectomy

(7) thoracotomy

(7) additional hepatic resection or ablation in addition to principal hepatic resection (in the implementation this was the presence of 2+ segments in 2 or 3 of the major zones)

(8) other major surgery

 

Extrahepatic procedures not making an hepatic resection "complex":

(1) cholecystectomy

(2) colostomy or iliostomy reversal

(3) hepatic wedge biopsy

(4) hepatic artery pump replacement

 


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