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
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