Portal vein-based subsegmental classification of liver segment four for parenchyma-sparing laparoscopic resection: A retrospective study

doi:10.3748/wjg.120736

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Nov 28, 2026; 32(44): 120736
Published online Nov 28, 2026. doi: 10.3748/wjg.120736

Portal vein-based subsegmental classification of liver segment four for parenchyma-sparing laparoscopic resection: A retrospective study

Kun Huang, Hai-Yang Hu, Kai Chen, Xing-Yu Chen, Zhu Chen, Yu Sun, Cheng-You Du, Gui-Xiong Chang, Hao Fu, Cong Hu, Heng Xiao, Xiang Lan

Kun Huang, Department of General Surgery, Mianyang Hospital of Traditional Chinese Medicine, Mianyang 621000, Sichuan Province, China

Hai-Yang Hu, Kai Chen, Xing-Yu Chen, Zhu Chen, Yu Sun, Cheng-You Du, Gui-Xiong Chang, Hao Fu, Cong Hu, Heng Xiao, Xiang Lan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400000, China

Co-first authors: Kun Huang and Hai-Yang Hu.

Co-corresponding authors: Heng Xiao and Xiang Lan.

Author contributions: Lan X and Xiao H designed the research study, revised the manuscript critically for important intellectual content and supervised the study and they contribute equally to this study as co-corresponding authors; Huang K and Hu HY developed the methodology and they contribute equally to this study as co-first authors; Chen K, Chen XY and Chen Z performed the investigation; Sun Y, Du CY, Chang GX, Fu H and Hu C collected and curated the data; Huang K performed the visualization and drafted the manuscript; and all authors have read and approved the final manuscript.

Supported by the 2024 University-Hospital Joint Innovation Fund of Chengdu University of Traditional Chinese Medicine, No. LH202402010.

Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University (Approval No. 2025-460-01).

Informed consent statement: The requirement for informed consent was waived by the Ethics Committee of the First Affiliated Hospital of Chongqing Medical University due to the retrospective nature of the study.

Conflict-of-interest statement: The authors declare no conflict of interest.

Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request. Because the study involves patient imaging data and institutional operative records, restrictions apply to their public availability due to ethical and privacy considerations.

Corresponding author: Xiang Lan, PhD, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Youyi Road, Yuzhong District, Chongqing 400000, China. lanxiang_tmmu@163.com

Received: March 10, 2026
Revised: April 8, 2026
Accepted: May 20, 2026
Published online: November 28, 2026
Processing time: 207 Days and 12.9 Hours

Core Tip

Core Tip: This study proposes a portal vein-based subsegmental classification of liver segment 4 (S4) derived from preoperative imaging and three-dimensional reconstruction. Intermediate branches crossing the falciform ligament were frequently identified, suggesting that the conventional boundary of S4 may not fully reflect its true portal territory. The proposed framework may support individualized parenchyma-sparing laparoscopic resection, particularly for type II anatomy. In the exploratory comparative follow-up dataset, no significant difference in overall survival or progression-free survival was observed between the novel and conventional groups. Formal validation remains necessary.