Abstract
Summary background data
Hepatectomy is a technically challenging surgery, and of all aspects of hepatic resection, caudate lobe resection is the most difficult. Knowledge of the anatomy of the caudate lobe is necessary to achieve safe caudate lobe resection.
Methodology
Hospital records of 54 patients, who had caudate lobe resection in our center from January 2000 to August 2007, were retrieved. The demographic data, clinicopathological features, and perioperative events were extracted and analyzed.
Results
Out of a total of 500 patients who had various forms of hepatic resection during the period in question, only 54 had caudate lobe resection (10.8%). Isolated caudate lobe resection (ICLR) was performed in 16 (29.6%) patients while the remainder had caudate lobe resection as a part of a major hepatectomy. Indications for hepatectomy in patients with ICLR include hepatocellular carcinoma, primary hepatic carcinoid tumor, cavernous hemangioma, and adenoma. Mean operative time for ICLR was 230 ± 50 min while it was 240 ± 50 min for right hepatectomy and 245 ± 55 min for left hepatectomy. The associated mean blood loss was 1200 ± 200, 1300 ± 350, and 1350 ± 350 ml, respectively. None of these were statistically significant. In patients who had ICLR, there was no mortality while three patients developed postoperative complications (bile leak in two patients and one patient with wound infection). Various forms of perioperative complications were noticed in six patients. All these patients, who also showed 7.8% mortality, had major hepatectomy.
Conclusions
Caudate lobe resection is a technically challenging procedure. Isolated caudate lobe resection is a safe procedure with good outcome in well selected patients. It is, however, associated with increased perioperative risks when associated with major hepatectomy.
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Abbreviations
- ICLR:
-
Isolated caudate lobe resection
- HCC:
-
Hepatocellular carcinoma
- PHCT:
-
Primary hepatic carcinoid tumor
References
Hawkins WG, DeMatteo RP, Cohen MS et al (2005) Caudate hepatectomy for cancer: a single institution experience with 150 patients. J Am Coll Surg 200:345–352
Jarnagin WR, Blumgart LH (2003) Caudate lobectomy. In: GJ Poston, LH Blumgart (eds) Surgical management of hepatobiliary and pancreatic disorders. Martin Dunitz Ltd, London and New York, pp 46–64
Glotzer DJ, Martini DJ, Sacks BA (1980) Caudate lobe resection to reduce inferior vena caval hypertension prior to portacaval shunt. Surgery 87:593–595
Lerut J, Gruwez JA, Blumgart LH (1990) Resection of the caudate lobe of the liver. Surg Gynecol Obstet 171:160–162
Elias D, Lasser PH, Desruennes E et al (1992) Surgical approach to segment I for malignant tumors of the liver. Surg Gynecol Obstet 175:17–24
Sarmiento JM, Que FG, Nagorney DM (2002) Surgical outcomes of isolated caudate lobe resection: a single series of 19 patients. Surgery 132:697–708 discussion -9
Bartlett D, Fong Y, Blumgart LH (1996) Complete resection of the caudate lobe of the liver: technique and results. Br J Surg 83:1076–1081
Nimura Y, Hayakawa N, Kamiya J et al (1990) Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus. World J Surg 14:535–543 discussion 44
Fan J, Wu ZQ, Tang ZY et al (2001) Complete resection of the caudate lobe of the liver with tumor: technique and experience. Hepatogastroenterology 48:808–811
Popescu I, Ciurea S, Romanescu D et al (2008) Isolated resection of the caudate lobe: indications, technique and results. Hepatogastroenterology 55:831–835
Sasada A, Ataka K, Tsuchiya K et al (1998) Complete caudate lobectomy: its definition, indications, and surgical approaches. HPB Surg 11:87–93 discussion -5
Yamamoto J, Kosuge T, Shimada K et al (1999) Anterior transhepatic approach for isolated resection of the caudate lobe of the liver. World J Surg 23:97–101
Hwang S, Lee SG, Lee YJ et al (2008) Modified liver hanging maneuver to facilitate left hepatectomy and caudate lobe resection for hilar bile duct cancer. J Gastrointest Surg 12:1288–1292
Chaib E, Ribeiro MA Jr, Silva Fde S et al (2008) Caudate lobectomy: tumor location, topographic classification, and technique using right- and left-sided approaches to the liver. Am J Surg 196:245–251
Peng SY, Li JT, Mou YP et al (2003) Different approaches to caudate lobectomy with "curettage and aspiration" technique using a special instrument PMOD: a report of 76 cases. World J Gastroenterol 9:2169–2173
Shimada M, Matsumata T, Maeda T et al (1994) Characteristics of hepatocellular carcinoma originating in the caudate lobe. Hepatology 19:911–915
Yamashita Y, Hamatsu T, Rikimaru T et al (2001) Bile leakage after hepatic resection. Ann Surg 233:45–50
Tanaka S, Shimada M, Shirabe K et al (2005) Surgical outcome of patients with hepatocellular carcinoma originating in the caudate lobe. Am J Surg 190:451–455
Yang MC, Lee PO, Sheu JC et al (1996) Surgical treatment of hepatocellular carcinoma originating from the caudate lobe. World J Surg 20:562–565 discussion 5-6
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Wahab, M.A., Lawal, A.R.O., EL Hanafy, E. et al. Caudate lobe resection: an Egyptian center experience. Langenbecks Arch Surg 394, 1057–1063 (2009). https://doi.org/10.1007/s00423-009-0554-0
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DOI: https://doi.org/10.1007/s00423-009-0554-0