Go Wakabayashi1, Daniel Cherqui2, David A Geller3, Mohammed Abu Hilal4, Giammauro Berardi5, Ruben Ciria6, Yuta Abe7, Takeshi Aoki8, Horacio J Asbun9, Albert C Y Chan10, Rawisak Chanwat11, Kuo-Hsin Chen12, Yajin Chen13, Tan To Cheung14, David Fuks15, Naoto Gotohda16, Ho-Seong Han17, Kiyoshi Hasegawa18, Etsuro Hatano19, Goro Honda20, Osamu Itano21, Yukio Iwashita22, Hironori Kaneko23, Yutaro Kato24, Ji Hoon Kim25, Rong Liu26, Santiago López-Ben27, Mamoru Morimoto28, Kazuteru Monden29, Fernando Rotellar30, Yoshihiro Sakamoto31, Atsushi Sugioka24, Tomoharu Yoshiizumi32, Keiichi Akahoshi33, Felipe Alconchel34, Shunichi Ariizumi20, Andrea Benedetti Cacciaguerra4, Manuel Durán6, Alain Garcia Vazquez35, Nicolas Golse2, Yoshihiro Miyasaka36, Yasuhisa Mori37, Satoshi Ogiso19, Chikara Shirata18, Federico Tomassini38, Takeshi Urade39, Taiga Wakabayashi7, Hitoe Nishino40,41, Taizo Hibi42, Norihiro Kokudo43, Masayuki Ohtsuka41, Daisuke Ban44, Yuichi Nagakawa40, Takao Ohtsuka45, Minoru Tanabe33, Masafumi Nakamura37, Akihiko Tsuchida40, Masakazu Yamamoto20. 1. Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan. 2. Hepatobiliary Center, Paul Brousse Hospital, Paris, France. 3. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. 4. Department of Surgery, Instituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy. 5. Department of General Surgery and Liver Transplantation Service, San Camillo Forlanini Hospital of Rome, Rome, Italy. 6. Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital Reina Sofía, IMIBIC, Cordoba, Spain. 7. Department of Surgery, Keio University School of Medicine, Tokyo, Japan. 8. Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan. 9. Hepato-Biliary and Pancreas Surgery, Miami Cancer Institute, Miami, Florida, USA. 10. Division of Liver Transplantation, Hepatobiliary & Pancreatic Surgery, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China. 11. Hepato-Pancreato-Biliary Surgery Unit, Department of Surgery, National Cancer Institute, Bangkok, Thailand. 12. Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 13. Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. 14. Department of Surgery, The University of Hong Kong, Hong Kong, China. 15. Department of Digestive and Oncologic Surgery, Institut Mutualiste Montsouris, Université Paris-Descartes, Paris, France. 16. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Chiba, Japan. 17. Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea. 18. Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 19. Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 20. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. 21. Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan. 22. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan. 23. Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan. 24. Department of Surgery, Fujita Health University, Aichi, Japan. 25. Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Gyeonggi-do, Korea. 26. Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepatobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, Beijing, China. 27. General Surgery Department, Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain. 28. Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan. 29. Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan. 30. HPB and Liver Transplant Unit, Clínica Universidad de Navarra, Pamplona, Spain. 31. Department of Hepato-Biliary-Pancreatic Surgery, Kyorin University Hospital, Tokyo, Japan. 32. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 33. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. 34. Department of Surgery and Transplantation, Virgen de la Arrixaca University Hospital (IMIB-Virgen de la Arrixaca), Murcia, Spain. 35. Institute of Image-Guided Surgery of Strasbourg, Strasbourg, France. 36. Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan. 37. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 38. General and Emergency Surgery Unit, GB Grassi Hospital, Rome, Italy. 39. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. 40. Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan. 41. Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. 42. Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan. 43. Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan. 44. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo, Japan. 45. First Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan.
Abstract
BACKGROUND: The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud's segments, did not address how to identify segmental borders and anatomic territories of less than one segment. Smaller anatomic resections including segmentectomies and subsegmentectomies, have not been well defined. The advent of minimally invasive liver resection has enhanced the possibilities of more precise resection due to a magnified view and reduced bleeding, and minimally invasive anatomic liver resection (MIALR) is becoming popular gradually. Therefore, there is a need for updating the Brisbane 2000 system, including anatomic segmentectomy or less. An online "Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)" was hosted on February 23, 2021. METHODS: The Steering Committee invited 34 international experts from around the world. The Expert Committee (EC) selected 12 questions and two future research topics in the terminology session. The EC created seven tentative definitions and five recommendations based on the experts' opinions and the literature review performed by the Research Committee. Two Delphi Rounds finalized those definitions and recommendations. RESULTS: This paper presents seven definitions and five recommendations regarding anatomic segmentectomy or less. In addition, two future research topics are discussed. CONCLUSIONS: The PAM-HBP Surgery Consensus has presented the Tokyo 2020 Terminology for Liver Anatomy and Resections. The terminology has added definitions of liver anatomy and resections that were not defined in the Brisbane 2000 system.
BACKGROUND: The Brisbane 2000 Terminology for Liver Anatomy and Resections, based on Couinaud's segments, did not address how to identify segmental borders and anatomic territories of less than one segment. Smaller anatomic resections including segmentectomies and subsegmentectomies, have not been well defined. The advent of minimally invasive liver resection has enhanced the possibilities of more precise resection due to a magnified view and reduced bleeding, and minimally invasive anatomic liver resection (MIALR) is becoming popular gradually. Therefore, there is a need for updating the Brisbane 2000 system, including anatomic segmentectomy or less. An online "Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM-HBP Surgery Consensus)" was hosted on February 23, 2021. METHODS: The Steering Committee invited 34 international experts from around the world. The Expert Committee (EC) selected 12 questions and two future research topics in the terminology session. The EC created seven tentative definitions and five recommendations based on the experts' opinions and the literature review performed by the Research Committee. Two Delphi Rounds finalized those definitions and recommendations. RESULTS: This paper presents seven definitions and five recommendations regarding anatomic segmentectomy or less. In addition, two future research topics are discussed. CONCLUSIONS: The PAM-HBP Surgery Consensus has presented the Tokyo 2020 Terminology for Liver Anatomy and Resections. The terminology has added definitions of liver anatomy and resections that were not defined in the Brisbane 2000 system.
Authors: D Osei-Bordom; L Hall; J Hodson; K Joshi; L Austen; D Bartlett; J Isaac; D F Mirza; R Marudanayagam; K Roberts; B V Dasari; N Chatzizacharias; R P Sutcliffe Journal: World J Surg Date: 2022-07-09 Impact factor: 3.282