Jarnaginet 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:
(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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