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Classification description | Surgical methods |
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Type I: lesions are identified in the parenchyma of liver segments V and VIII or both segments and are distinguished by their closeness to, or even direct violation of, the next portal vein. They do not cling to the right hepatic vein trunk or compress it | Excision of liver segments V and VIII ± partial intervention of segment IV |
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Type II: lesions are located in the parenchyma of hepatic segments IVa and IVb or both segments and are distinguished by their proximity to, or even direct violation of, the left hepatic vein branch. Furthermore, it does not attach to or compress the trunk of the left hepatic vein | Excision of liver segments IVa and IVb or left hepatectomy |
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Type III: most of the liver parenchyma in segments IV, V, and VIII is occupied by the lesions, which is characterized by a wide and deep invasion of the parenchyma, as well as proximity to the main hepatic vein | Central bisectionectomy (removal of segments IV, V, and VIII±I) |
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Type IV: most liver parenchyma in segments IV, V, and VIII is occupied by lesions, which is distinguished by its closeness to, or direct violation of, the left/right portal vein branch or the left/right hepatic vein. | Excision of segment IV, V, VI, VII, and VIII removal reduced right trisectionectomy or reduced left trisectionectomy Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) |
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Type V: the superficial liver parenchyma of segments IV, V, and VIII is occupied by this form of liver tumor. Neither the portal branch nor the hepatic vein is near the lesions | Hepatectomy with a negative margin |
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