A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection

Cappelle, Marie; Poel, Marcel J. van der; Besselink, Marc G.; Sergeant, Gregory; Edwin, Bjørn; Parmentier, Isabelle; Meyere, Céline De; Vansteenkiste, Franky; D’Hondt, Mathieu

doi:10.1007/s00423-020-01867-2

Cited by 10 publications

(18 citation statements)

References 38 publications

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“…Table 3 Subgroup analysis according to the surgical procedure of S1 resection, resection limited to Spiegel lobe (S1-S) and resection of the Spiegel lobe extended to the paracaval portion and complete/partial resection of caudate process (S1-S + P) Few articles concerning the laparoscopic approach to CL are published in literature. Moreover, the majority of these studies are limited to case reports or small surgical series [5,[8][9][10][11][12][13][14][15][16]. Table 4 provides a literature review and demonstrates that morbidity rate of MILS CL resections ranged from 0 to 33% with no postoperative mortality.…”

Section: Discussionmentioning

confidence: 99%

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Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

et al. 2021

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Background Although isolated caudate lobe (CL) liver resection is not a contraindication for minimally invasive liver surgery (MILS), feasibility and safety of the procedure are still poorly investigated. To address this gap, we evaluate data on the Italian prospective maintained database on laparoscopic liver surgery (IgoMILS) and compare outcomes between MILS and open group. Methods Perioperative data of patients with malignancies, as colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), non-colorectal liver metastases (NCRLM) and benign liver disease, were retrospectively analyzed. A propensity score matching (PSM) analysis was performed to balance the potential selection bias for MILS and open group. Results A total of 224 patients were included in the study, 47 and 177 patients underwent MILS and open isolated CL resection, respectively. The overall complication rate was comparable between the two groups; however, severe complication rate (Dindo–Clavien grade ≥ 3) was lower in the MILS group (0% versus 6.8%, P = ns). In-hospital mortality was 0% in both groups and mean hospital stay was significantly shorter in the MILS group (P = 0.01). After selection of 42 MILS and 43 open CL resections by PSM analysis, intraoperative and postoperative outcomes remained similar except for the hospital stay which was not significantly shorter in MILS group. Conclusions This multi-institutional cohort study shows that MILS CL resection is feasible and safe. The surgical procedure can be technically demanding compared to open resection, whereas good perioperative outcomes can be achieved in highly selected patients.

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Section: Discussionmentioning

confidence: 99%

“…MILS approaches to the CL have specific technical challenges: proximity to the IVC, major hepatic veins and the hepatic hilum [7]. Surgical series of MILS for the caudate lobe in the literature are limited and only a few reports describing more than 5 cases have been published [5,[8][9][10][11][12][13][14][15][16].…”

mentioning

confidence: 99%

Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

et al. 2021

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“…Topographical nomenclature used for hepatic segments in the United States was proposed by Healy and Schroy [26] : segment I left and segment I right, while nomenclature used in Europe was proposed by Couinaud [27] : segment I and segment IX. However, Kumon [28] classified the caudate lobe into 3 portions through the investigation using corrosion liver casts and this classification has been widely used.…”

Section: Anatomy Of the Caudate Lobementioning

confidence: 99%

“…The caudate lobe is an autonomous segment of the liver; it consists of 3 parts according to Kumon's nomenclature: the Spiegel lobe, the paracaval portion, and the caudate process [28] . The Spiegel lobe is located to the left of the retrohepatic IVC and the Arantius' ligament.…”

Section: Anatomy Of the Caudate Lobementioning

confidence: 99%

“…A single branch from the left portal vein predominantly feeds the paracaval portion but the bile duct drains to the right or left system in almost equal frequencies. And for the caudate process, the portal vein usually branches from the right portal vein and the bile duct from the right posterior hepatic duct [28] . Venous drainage occurs along the posterior aspect of the caudate lobe directly into the IVC through multiple short hepatic veins which vary in number and size [29] .…”

Section: Anatomy Of the Caudate Lobementioning

confidence: 99%

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Laparoscopic isolated caudate lobectomy for HCC

Kim¹,

Kwon²

2021

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Hepatocellular carcinoma (HCC) located in caudate lobectomy is not common, but caudate lobectomy is associated with technical difficulty and high degree of operative risk due to deep location of the caudate lobe and surrounding major vasculature. Recently, with advances in technology and accumulation of techniques, minimal invasive surgery has been widely performed in the field of liver surgery. However, laparoscopic isolated caudate lobectomy is still technically challenging which requires in-depth knowledge of the anatomy of the caudate and extensive experience in laparoscopic liver surgery. This review focuses on the surgical techniques and outcomes of laparoscopic isolated caudate lobectomy. Although it is difficult to make conclusion regarding oncologic outcome because only a few studies with limited case numbers have reported oncologic outcome of laparoscopic isolated caudate lobectomy for HCC, laparoscopic approach could be performed safely with several benefits and become a favorable method for isolated caudate lobectomy, especially for surgeons with relatively large experience in laparoscopic liver surgery.

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Laparoscopic liver resection versus radiofrequency ablation for caudate lobe solitary hepatocellular carcinoma: A propensity score matching study

Wang,

Ouyang,

Jia

et al. 2024

Cancer Medicine

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ObjectiveThis study aimed to compare the clinical efficacy of laparoscopic liver resection (LLR) and radiofrequency ablation (RFA) in treating solitary hepatocellular carcinoma (HCC) of the hepatic caudate lobe.MethodsPatients with hepatic caudate lobe HCC who underwent LLR or RFA at three hospitals in China between February 2015 and February 2021 were included. In total, 112 patients met the inclusion criteria, of whom 52 underwent RFA and 60 underwent LLR. The outcomes of the two groups were compared and analyzed using propensity score matching (PSM) method.ResultsThere were no significant differences between the two groups in terms of sex, HBV/HCV positivity, AFP positivity (>100 ng/mL), tumor position, Child–Pugh score, or preoperative liver function tests (ALT, AST, TBIL, ALB, and PT) (p > 0.05). Compared to the LLR group, the RFA group had a shorter operation time, less intraoperative bleeding, and shorter postoperative hospital stay (p < 0.05). There was no statistically significant difference in overall postoperative complications between the two groups (p > 0.05). Despite the larger tumor size, the LLR group had better postoperative recurrence‐free survival (RFS) (p = 0.00027) and overall survival (OS) (p = 0.0023) than the RFA group. After one‐to‐one PSM, 31 LLR patients and 31 RFA patients were selected for further analyses. The advantages of LLR over RFA were observed in terms of RFS (p < 0.0001) and OS (p = 0.00029).ConclusionLLR should probably be recommended as the preferred method for solitary caudate lobe HCC.

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A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection

Cited by 10 publications

References 38 publications

Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

Technical feasibility and short-term outcomes of laparoscopic isolated caudate lobe resection: an IgoMILS (Italian Group of Minimally Invasive Liver Surgery) registry-based study

Laparoscopic isolated caudate lobectomy for HCC

Laparoscopic liver resection versus radiofrequency ablation for caudate lobe solitary hepatocellular carcinoma: A propensity score matching study

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