Amanda K Arrington MD

Surgical Oncology
Assistant Professor
UGGHHHHHHHHH!!!!
Which segment???
 THINK…..
1. Relationship with Portal Vein
2. Relationship with Hepatic Vein
3. About Your Right Fist….

Hepatic Vein

7 8 4A 2

6 5 4B 3
Portal Vein
 Above Portal Vein…..
Know
you are
ABOVE
Portal
Vein--- 4A
cannot 2
see
portal
8
vein or 1
main
branches 7
on CT!
Below the Portal Vein….

Know
you are 4B
below 3
Portal
Vein if 5
you can
see
1
portal
branches
or main 6
PV on
CT (Red
Circle)
POP QUIZ: Which segment???

1. Below level of PV
a) INFERIOR
LOBES….
i. 3, 4B, 5, 6
2. Right of Right Hepatic
PV V

SEGMENT 6
Now…which segment????
1. Above Confluence of PV
a) SUPERIOR LOBES….
i. 2, 4A, 7, 8
2. Probably border or just
left to Right Hepatic V
a) SEGMENT 7, 8

SEGMENT 8
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1
 Brisbane 2000 Liver
Terminology
Right hepatectomy or right
hemihepatectomy
Left hepatectomy or left
hemihepatectomy
Right trisectionectomy or extended
right hepatectomy
Left trisectionectomy or extended
left hepatectomy
Left lateral sectionectomy or
bisegmentectomy 2, 3
Right posterior sectionectomy
Caudate lobectomy or
segmentectomy 1