Kawaguchi et al reported a classification for difficulty levels when performing a primary laparoscopic hepatectomy. The authors are from the InstitutMutualisteMontsouris (Paris) and the University of Tokyo.
Resection |
Difficulty Level |
wedge resection, anterolateral (AL) segment |
Grade I (low) |
wedge resection, posterosuperior (PS) segment |
Grade I (low) |
left lateral sectionectomy |
Grade I (low) |
segmentectomy, AL segment |
Grade II (intermediate) |
left hepatectomy (segments 2, 3, and 4 +/- 1) |
Grade II (intermediate) |
segmentectomy, PS segment |
Grade III (high) |
right hepatectomy (segments 5, 6, 7 and 8 +/- 1) |
Grade III (high) |
extended right hepatectomy (segments 4, 5, 6, 7 and 8 +/- 1) |
Grade III (high) |
right posterior sectionectomy (segments 6 and 7) |
Grade III (high) |
central hepatectomy (segments 5 and 8 +/- 4) |
Grade III (high) |
extended left hepatectomy(segments 1, 2, 3, 4, 5 and 8) |
Grade III (high) |
Wedge |
Sectionectomy |
Segmentectomy |
Hepatectomy |
Grade |
AL segment |
|
|
|
I |
PS segment |
|
|
|
I |
|
left lateral |
|
|
I |
|
right posterior |
|
|
III |
|
|
AL segment |
|
II |
|
|
PS segment |
|
III |
|
|
|
left |
II |
|
|
|
right |
III |
|
|
|
extended left |
III |
|
|
|
extended right |
III |
|
|
|
central |
III |
Specialty: Gastroenterology