Redefining major hepatic resection for colorectal liver metastases: Analysis of 1111 liver resections

Abstract Introduction A major hepatic resection is currently defined as resection of 3 or more segments. The aim of this study was to analyse the post-operative morbidity and mortality of hepatic resections in relation to the number of segments excised. Patients and methods From January 2000 to December 2010, 1111 liver resections were performed for colorectal liver metastases (CRLM). Data were collected from a prospectively maintained database and analysed according to the extent of resection performed. Results 457 patients had 1–2, 362 had 3–4 and 292 had 5–6 segments resected respectively. In comparing 1–4 vs. 5–6 segments, overall morbidity (16.7% vs 40.7%; p  Conclusions Differences in outcome would suggest a revision of the current classification. Only when 5 or more segments are excised for CRLM should a liver resection be considered "major".