The Tokyo 2020 Terminology of Liver Anatomy and Resections: Updates of the Brisbane 2000 system
Go Wakabayashi 1 , Daniel Cherqui 2 , David A Geller 3 , Mohammed Abu Hilal 4 , Giammauro Berardi 5 , Ruben Ciria 6 , Yuta Abe 7 , Takeshi Aoki 8 , Horacio J Asbun 9 , Albert C Y Chan 10 , Rawisak Chanwat 11 , Kuo-Hsin Chen 12 , Yajin Chen 13 , Tan To Cheung 14 , David Fuks 15 , Naoto Gotohda 16 , Ho-Seong Han 17 , Kiyoshi Hasegawa 18 , Etsuro Hatano 19 , Goro Honda 20 , Osamu Itano 21 , Yukio Iwashita 22 , Hironori Kaneko 23 , Yutaro Kato 24 , Ji Hoon Kim 25 , Rong Liu 26 , Santiago López-Ben 27 , Mamoru Morimoto 28 , Kazuteru Monden 29 , Fernando Rotellar 30 , Yoshihiro Sakamoto 31 , Atsushi Sugioka 24 , Tomoharu Yoshiizumi 32 , Keiichi Akahoshi 33 , Felipe Alconchel 34 , Shunichi Ariizumi 20 , Andrea Benedetti Cacciaquerra 4 , Manuel Durán 6 , Alain Garcia Vazquez 35 , Nicolas Golse 2 , Yoshihiro Miyasaka 36 , Yasuhisa Mori 37 , Satoshi Ogiso 38 , Chikara Shirata 18 , Federico Tomassini 39 , Takeshi Urade 40 , Taiga Wakabayashi 7 , Hitoe Nishino 41 42 , Taizo Hibi 43 , Norihiro Kokudo 44 , Masayuki Ohtsuka 42 , Daisuke Ban 45 , Yuichi Nagakawa 41 , Takao Ohtsuka 46 , Minoru Tanabe 33 , Masafumi Nakamura 37 , Akihiko Tsuchida 41 , Masakazu Yamamoto 20
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 2 future research topics in the terminology session. The EC created 7 tentative definitions and 5 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 7 definitions and 5 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.
CITATION J Hepatobiliary Pancreat Sci. 2022 Jan;29(1):6-15. doi: 10.1002/jhbp.1091 Epub 2021 Dec 20.