Volume 29, Issue 1 pp. 6-15
CONSENSUS STATEMENT

The Tokyo 2020 terminology of liver anatomy and resections: Updates of the Brisbane 2000 system

Go Wakabayashi

Corresponding Author

Go Wakabayashi

Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, Saitama, Japan

Correspondence

Go Wakabayashi, Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama 362-8588, Japan.

Email: [email protected]

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Daniel Cherqui

Daniel Cherqui

Hepatobiliary Center, Paul Brousse Hospital, Paris, France

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David A. Geller

David A. Geller

Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA

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Mohammed Abu Hilal

Mohammed Abu Hilal

Department of Surgery, Instituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy

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Giammauro Berardi

Giammauro Berardi

Department of General Surgery and Liver Transplantation Service, San Camillo Forlanini Hospital of Rome, Rome, Italy

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Ruben Ciria

Ruben Ciria

Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital Reina Sofía, IMIBIC, Cordoba, Spain

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Yuta Abe

Yuta Abe

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Takeshi Aoki

Takeshi Aoki

Department of Gastroenterological and General Surgery, School of Medicine, Showa University, Tokyo, Japan

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Horacio J. Asbun

Horacio J. Asbun

Hepato-Biliary and Pancreas Surgery, Miami Cancer Institute, Miami, Florida, USA

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Albert C. Y. Chan

Albert C. Y. Chan

Division of Liver Transplantation, Hepatobiliary & Pancreatic Surgery, Department of Surgery, The University of Hong Kong, Hong Kong SAR, China

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Rawisak Chanwat

Rawisak Chanwat

Hepato-Pancreato-Biliary Surgery Unit, Department of Surgery, National Cancer Institute, Bangkok, Thailand

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Kuo-Hsin Chen

Kuo-Hsin Chen

Department of Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan

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Yajin Chen

Yajin Chen

Department of Hepatobiliary Surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China

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Tan To Cheung

Tan To Cheung

Department of Surgery, The University of Hong Kong, Hong Kong, China

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David Fuks

David Fuks

Department of Digestive and Oncologic Surgery, Institut Mutualiste Montsouris, Université Paris-Descartes, Paris, France

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Naoto Gotohda

Naoto Gotohda

Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Chiba, Japan

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Ho-Seong Han

Ho-Seong Han

Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea

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Kiyoshi Hasegawa

Kiyoshi Hasegawa

Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

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Etsuro Hatano

Etsuro Hatano

Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

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Goro Honda

Goro Honda

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

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Osamu Itano

Osamu Itano

Department of Hepato-Biliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan

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Yukio Iwashita

Yukio Iwashita

Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Oita, Japan

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Hironori Kaneko

Hironori Kaneko

Division of General and Gastroenterological Surgery, Department of Surgery, Toho University Faculty of Medicine, Tokyo, Japan

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Yutaro Kato

Yutaro Kato

Department of Surgery, Fujita Health University, Aichi, Japan

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Ji Hoon Kim

Ji Hoon Kim

Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Gyeonggi-do, Korea

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Rong Liu

Rong Liu

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

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Santiago López-Ben

Santiago López-Ben

General Surgery Department, Hospital Universitari de Girona Dr Josep Trueta, Girona, Spain

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Mamoru Morimoto

Mamoru Morimoto

Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Science, Nagoya, Japan

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Kazuteru Monden

Kazuteru Monden

Department of Surgery, Fukuyama City Hospital, Hiroshima, Japan

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Fernando Rotellar

Fernando Rotellar

HPB and Liver Transplant Unit, Clínica Universidad de Navarra, Pamplona, Spain

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Yoshihiro Sakamoto

Yoshihiro Sakamoto

Department of Hepato-Biliary-Pancreatic Surgery, Kyorin University Hospital, Tokyo, Japan

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Atsushi Sugioka

Atsushi Sugioka

Department of Surgery, Fujita Health University, Aichi, Japan

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Tomoharu Yoshiizumi

Tomoharu Yoshiizumi

Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

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Keiichi Akahoshi

Keiichi Akahoshi

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

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Felipe Alconchel

Felipe Alconchel

Department of Surgery and Transplantation, Virgen de la Arrixaca University Hospital (IMIB-Virgen de la Arrixaca), Murcia, Spain

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Shunichi Ariizumi

Shunichi Ariizumi

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

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Andrea Benedetti Cacciaguerra

Andrea Benedetti Cacciaguerra

Department of Surgery, Instituto Ospedaliero Fondazione Poliambulanza, Brescia, Italy

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Manuel Durán

Manuel Durán

Unit of Hepatobiliary Surgery and Liver Transplantation, University Hospital Reina Sofía, IMIBIC, Cordoba, Spain

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Alain Garcia Vazquez

Alain Garcia Vazquez

Institute of Image-Guided Surgery of Strasbourg, Strasbourg, France

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Nicolas Golse

Nicolas Golse

Hepatobiliary Center, Paul Brousse Hospital, Paris, France

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Yoshihiro Miyasaka

Yoshihiro Miyasaka

Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan

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Yasuhisa Mori

Yasuhisa Mori

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

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Satoshi Ogiso

Satoshi Ogiso

Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan

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Chikara Shirata

Chikara Shirata

Hepato-Biliary-Pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan

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Federico Tomassini

Federico Tomassini

General and Emergency Surgery Unit, GB Grassi Hospital, Rome, Italy

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Takeshi Urade

Takeshi Urade

Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

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Taiga Wakabayashi

Taiga Wakabayashi

Department of Surgery, Keio University School of Medicine, Tokyo, Japan

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Hitoe Nishino

Hitoe Nishino

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan

Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan

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Taizo Hibi

Taizo Hibi

Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan

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Norihiro Kokudo

Norihiro Kokudo

Department of Surgery, National Center for Global Health and Medicine, Tokyo, Japan

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Masayuki Ohtsuka

Masayuki Ohtsuka

Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan

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Daisuke Ban

Daisuke Ban

Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo, Japan

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Yuichi Nagakawa

Yuichi Nagakawa

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan

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Takao Ohtsuka

Takao Ohtsuka

First Department of Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

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Minoru Tanabe

Minoru Tanabe

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan

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Masafumi Nakamura

Masafumi Nakamura

Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

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Akihiko Tsuchida

Akihiko Tsuchida

Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan

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Masakazu Yamamoto

Masakazu Yamamoto

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan

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First published: 06 December 2021
Citations: 34

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.

CONFLICT OF INTEREST

The authors declare no conflicts of interest.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.