Landmarks to identify segmental borders of the liver: A review prepared for PAM-HBP expert consensus meeting 2021

Study group of Precision Anatomy for Minimally Invasive Hepato-Biliary-Pancreatic surgery (PAM-HBP surgery)

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)


Background: In preparation for the upcoming consensus meeting in Tokyo in 2021, this systematic review aimed to analyze the current available evidence regarding surgical anatomy of the liver, focusing on useful landmarks, strategies and technical tools to perform precise anatomic liver resection (ALR). Methods: A systematic review was conducted on MEDLINE/PubMed for English articles and on Ichushi database for Japanese articles until September 2020. The quality assessment of the articles was performed in accordance with the Scottish Intercollegiate Guidelines Network (SIGN). Results: A total of 3169 manuscripts were obtained, 1993 in English and 1176 in Japanese literature. Subsequently, 63 English and 20 Japanese articles were selected and reviewed. The quality assessment of comparative series and case series was revealed to be usually low; only six articles were qualified as high quality. Forty-two articles focused on analyzing intersegmental/sectional planes and their relationship with specific hepatic landmark veins. In 12 articles, the authors aimed to investigate liver surface anatomic structures, while 36 articles aimed to study technological tools and contrast agents for surgical segmentation during ALR. Although Couinaud's classification has remained the cornerstone in daily diagnostic/surgical practices, it does not always portray the realistic liver segmentation and there has been no standardization on which a single strategy should be followed to perform precise ALR. Conclusions: A global consensus should be pursued in order to establish clear guidelines and proper recommendations to perform ALR in the era of minimally invasive surgery.

Original languageEnglish
Pages (from-to)82-98
Number of pages17
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Issue number1
Publication statusPublished - 2022 Jan
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Hepatology


Dive into the research topics of 'Landmarks to identify segmental borders of the liver: A review prepared for PAM-HBP expert consensus meeting 2021'. Together they form a unique fingerprint.

Cite this