The evolution of anatomical hepatectomy: Past, present, and future

Abstract

The liver contains a complex structure of blood vessels and bile ducts, and the vascular structure is highly variable. The anatomical segmentation of the liver is still controversial, and the Couinaud segmentation method based on the portal vein is more widely used in clinical practice. The treatment of liver tumors and other lesions is closely related to the liver anatomy. The mechanism of liver tumor invasion and metastasis is complex, and it is currently believed that tumor invasion mainly spreads along the portal vein. Anatomic liver resection is an important surgical method for liver diseases, especially liver tumors. This article reviews the vascular structure of the liver, the development of anatomical hepatectomy, blood flow control, surgical planning, intraoperative navigation, minimally invasive surgery, and precise hepatectomy. Anatomic liver resection is a part of precision liver surgery, which is becoming increasingly more precise in terms of surgical evaluation, surgical planning, and surgical operation. New technologies will facilitate precision surgery with less trauma and greater benefits for patients. With the development and advancement of technology, image-based surgical planning and intraoperative surgical navigation will become more widely used in precision liver surgery.