Appendix Q1 - LIVER

Q.1: LIVER INTRATRAHEPATIC BILE DUCTS

For Cases Diagnosed prior to January 1, 2003

C22.0-C22.1

SURGICAL APPROACH

Code	Description
0	None; no cancer-directed surgery of primary site
1	Endoscopy only, NOS (laparoscopy)
2		Not image guided
3		Image guided
4	Open, NOS
		Not assisted by endoscopy
		Assisted by endoscopy
9	Unknown; not stated; death certificate only

SURGERY OF PRIMARY SITE

Code	Description
00	None; no cancer-directed surgery of primary site
10	Local tumor destruction, NOS
11		Photodynamic therapy (PDT)
12		Electrocautery; fulguration Note: Includes use of hot forceps for tumor destruction.
13		Cryosurgery
14		Laser
15		Alcohol (PEI)
16		Heat
17		Other (ultrasound, acetic acid)
20	Wedge resection, NOS; segmental resection
30	Lobectomy, NOS
31		Simple
32		Extended Extended lobectomy: resection of a single lobe plus a segment of another lobe.
40	Excision of a bile duct Note: for an intrahepatic bile duct primary only.
70	Total hepatectomy with transplant Note: Liver transplant must also be coded under the data item Reconstruction/Restoration.
80	Hepatectomy, NOS
90	Surgery, NOS
99	Unknown if cancer-directed surgery performed; death certificate only

SURGICAL MARGINS

Code	Description
0	All margins grossly and microscopically negative
1	Margins involved, NOS
2		Microscopic involvement
5		Macroscopic involvement
7	Margins not documented
8	No cancer-directed surgery of primary site
9	Unknown whether margins were involved or negative; death certificate only

SCOPE OF REGIONAL LYMPH NODE SURGERY

Regional lymph nodes are the hilar nodes:

Along the portal vein
Along the inferior vena cava
Along the proper hepatic artery
At the hepatic pedicle

Code	Description
0	No regional lymph nodes removed
1	Regional lymph nodes removed, NOS
9	Unknown; not stated; death certificate only

NUMBER OF REGIONAL LYMPH NODES EXAMINED

Code	Description
00	No regional lymph nodes removed
01	One regional lymph node removed
02	Two regional lymph nodes removed
..
90	Ninety or more regional lymph nodes removed
95	No regional lymph nodes removed but aspiration of regional lymph nodes was performed
96	Regional lymph node removal documented as a sampling and number of lymph nodes unknown/not stated
97	Regional lymph node removal documented as dissection and number of lymph nodes unknown/not stated
98	Regional lymph nodes surgically removed but number of lymph nodes unknown/not stated and not documented as sampling or dissection
99	Unknown; not stated; death certificate only

SURGERY OF OTHER REGIONAL SITE(S), DISTANT SITE(S) OR DISTANT LYMPH NODE(S)

Code	Description
0	None; no surgery to other regional or distant sites
1	Surgery to other sites or nodes, NOS; unknown if regional or distant
2		Other regional sites
3		Distant lymph nodes Note: Includes inferior phrenic lymph nodes.
4		Distant sites
5		Combination of 4 with 2 or 3
9	Unknown; not stated; death certificate only

RECONSTRUCTION/RESTORATION - FIRST COURSE

Code	Description
0	No reconstruction/restoration
1	Rioux en Y; hepatojejunostomy including stent
2	Liver transplant
9	Unknown; not stated; death certificate only

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