Operative terminology and post-operative management approaches applied to hepatic surgery: Trainee perspectives

Table 1 Brisbane consensus nomenclature 2000 for describing hepatic resectional surgery based on liver segmental and sectorial anatomy

Anatomical term	Couinaud segments	Term for HRS	Major or minor resection
Right hemi liver	5, 6, 7, 8	Right hemihepatectomy or right hemihepatectomy	Major
Left hemi liver	2, 3, 4 (+/- 1)	Left hemihepatectomy or left hemihepatectomy	Major
Right anterior section	5, 8	Right anterior sectionectomy	Minor
Right posterior section	6, 7	Right posterior sectionectomy	Minor
Left medial section	4	Left medial sectionectomy or resection segment 4 or segmentectomy 4	Minor
Left lateral section	2, 3	Left lateral sectionectomy or bisegmentectomy 2, 3	Minor
-	4, 5, 6, 7, 8 , (+/- 1)	Right trisectionectomy or extended right hemihepatectomy or extended right hepatectomy	Major
-	2, 3, 4, 5, 8 , (+/- 1)	Left trisectionectomy or extended left hemihepatectomy or extended left hepatectomy	Major

"Non-anatomical" resections are also performed either as the main index procedure or in combination with the above anatomical hepatic resectional surgery. A non-anatomical resection refers to a situation in which there is a small tumour that is excised with a negative margin but leaving a remnant segment – a so-called "chip-shot" or metastectomy.

Table 2 Abridged version of West Haven criteria

HE grade	Mental state
1	Mild confusion, slowing of ability to do mental tasks, e.g., serial 7’s
2	Drowsiness, inappropriate behaviour
3	Somnolent but rousable, marked confusion
4	Coma

Reproduced with permission from reference Ferenci et al[79].