Reproposal for Hjortsjo's segmental anatomy on the anterior segment in human liver.

Abstract

A LIMITED HEPATIC resection is often used in treating small hepatocellular carcinoma located in the cirrhotic liver with severe liver function. To achieve both a cure of the tumor and the preservation of liver function, a minimum, but necessary, amount of the cancer-containing liver tissue is to be excised.¹ The simplest resection involves removing only a small wedge of liver tissue containing the tumor. When a lesion is not amenable to simple wedge resection owing to either its size or location, segmental resection must be performed.² In performing this procedure, the segmental anatomy concepts introduced by Healey and Schroy³ or Couinaud⁴ are widely used. However, liver surgeons have difficulties in performing the subsegmental resection of the anterior segment according to these segmental anatomies.⁵ Because the border between segments 5 and 8 was drawn as an imaginary transverse line through the right portal vein, there is no anatomical structure defining it.