Parenchymal-sparing liver surgery in patients with colorectal carcinoma liver metastases

Figure 2 Diagram of segment-oriented parenchymal-sparing resections according to different surgical scenarios. A: Metastatic lesion infiltrating the RHV; A1: Right hepatectomy; A2: Bisegmentectomy 7-8 is possible due to the presence of an IRHV; B: Metastatic lesions located in S5-6; B1: Right hepatectomy; B2: Bisegmentectomy 5-6; C: Metastatic lesions in right posterior section; C1: Right hepatectomy; C2: Right posterior sectionectomy; D: Large central tumors invading the MHV; D1: Left trisectionectomy; D2: Central hepatectomy; E: Metastatic lesions invading the RHV and the MHV; E1: Right trisectionectomy extended to S2; E2: Upper transversal hepatectomy is possible due to the presence of an IRHV and communicating hepatic veins. PS: Parenchymal-sparing; RHV: Right hepatic vein; IRHV: Inferior right hepatic vein; MHV: Middle hepatic vein.