Review
Copyright ©The Author(s) 2016.
World J Gastrointest Surg. Jun 27, 2016; 8(6): 407-423
Published online Jun 27, 2016. doi: 10.4240/wjgs.v8.i6.407
Figure 1
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Figure 1 Diagram of liver segmentation and the anatomical variations of hepatic outflow important for parenchymal-sparing liver resections. CVs: Communicating hepatic veins; IRHV: Inferior right hepatic vein.
Figure 2
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Figure 2 Diagram of segment-oriented parenchymal-sparing resections according to different surgical scenarios. A: Metastatic lesion infiltrating the RHV; A1: Right hepatectomy; A2: Bisegmentectomy 7-8 is possible due to the presence of an IRHV; B: Metastatic lesions located in S5-6; B1: Right hepatectomy; B2: Bisegmentectomy 5-6; C: Metastatic lesions in right posterior section; C1: Right hepatectomy; C2: Right posterior sectionectomy; D: Large central tumors invading the MHV; D1: Left trisectionectomy; D2: Central hepatectomy; E: Metastatic lesions invading the RHV and the MHV; E1: Right trisectionectomy extended to S2; E2: Upper transversal hepatectomy is possible due to the presence of an IRHV and communicating hepatic veins. PS: Parenchymal-sparing; RHV: Right hepatic vein; IRHV: Inferior right hepatic vein; MHV: Middle hepatic vein.
Figure 3
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Figure 3 Diagram of non-segment-oriented parenchymal-sparing resections according to different surgical scenarios. A: Metastatic lesion in S2; A1: Left lateral sectionectomy; A2: Atypical resection of S2; B: Metastatic lesion infiltrating the MHV close to the hepato-caval confluence; B1: Central hepatectomy; B2: Mini-mesohepatectomy is possible due to the presence of communicating hepatic veins; C: Metastatic lesions in right posterior section invading the RHV and tumor in proximity of right anterior portal branch; C1: Right hepatectomy; C2: Systematic extended right posterior sectionectomy; D: Liver metastases peripherally located in S3, 4b, 5, 6 and 7; D1: Right trisectionectomy; D2: Lower inferior hepatectomy; E: Multiple bilateral metastases; E1: Atypical resections combined with central hepatectomy; E2: Multiple atypical resections combined with radiofrequency ablation. PS: Parenchymal-sparing; RHV: Right hepatic vein; MHV: Middle hepatic vein.