Related Experiment Video
Updated: Aug 5, 2026
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Right (H145678) and Left (H123458) 6-Segmentectomies for Malignant Liver Tumors: A Retrospective Analysis of 237
Daniel Azoulay1, Pio Corleone, Goudarz T Passand
1Department of HPB and LT surgery, Centre Hépato-Biliaire, Hôpital Universitaire Paul Brousse, Université Paris-Saclay, INSERM U1193, Villejuif, France.
Objective:
Analysis of 6-segmentectomies coded H145678 or H123458 in the New World classification of liver resections using contemporary indicators to improve the shared surgical decision-making.
Summary Of Background Data:
Specific reports on H145678 and H123458 have lacked granularity or have focused on perihilar cancer.
Methods:
We performed a retrospective single-center analysis of consecutive patients who underwent H145678 or H123458 from 1993 to 2024. Surgical futility (90 d mortality), failure-to-rescue, oncological futility (early tumor recurrence), and outcome futility (surgical or oncologic futility) were evaluated. Textbook outcome achievement and the potential role of liver transplantation (LT) were also assessed.
Results:
The study population included 237 patients with perihilar cholangiocarcinoma (n=117, 49.4%), intrahepatic cholangiocarcinoma (n=39, 16.4%), hepatocellular carcinoma (n=17, 7.2%), colorectal cancer liver metastases (n=38, 16.0%), or miscellaneous tumors (n=26, 11%). H145678 and H123458 were performed in 166 (70.0%) and 71 (30.0%) patients, respectively. Combined vascular and bile duct reconstructions were performed in 46.4% (n=110) and 62.4% (n=148) of patients, respectively. Rates of surgical, failure-to-rescue, oncological, and outcome futility were 15.6% (n=37), 30.3% (n=37), 14.5% (n=29), and 27.8% (n=66), respectively. Textbook outcome was achieved in 30.8% (n=73). With a median follow-up of 26 months, 5-year overall-survival rates and disease-free survival rates were 30.8% and 18.9%. LT criteria were not met in 94.9% (n=225).
Conclusions:
H123458 and H145678 offer selected patients a chance for long-term survival. LT is not a therapeutic option for most patients, and targeted rescue strategies may improve failure-to-rescue rates.
