Caudate lobectomy: tumor location, topographic classification, and technique using right- and left-sided approaches to the liver

Chaib, Eleazar; Ribeiro, Marcelo Augusto Fontenelle; Silva, Francisco de S. Collet; Saad, William Abrão; Cecconello, Ivan

doi:10.1016/j.amjsurg.2007.11.020

Cited by 38 publications

(27 citation statements)

References 15 publications

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“…The approach to the caudate lobe depends on the location of the tumor and the expertise of the surgeon. That new approaches are still being devised to the caudate lobe is a testimony to the fact there is no approach that is superior to the other [11][12][13][14][15]. In our series, our approach to the caudate lobe was based on the location of the tumor.…”

Section: Discussionmentioning

confidence: 95%

Caudate lobe resection: an Egyptian center experience

Wahab

Lawal

Hanafy

et al. 2009

Langenbecks Arch Surg

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Section: Discussionmentioning

confidence: 95%

Caudate lobe resection: an Egyptian center experience

Wahab

Lawal

Hanafy

et al. 2009

Langenbecks Arch Surg

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“…12 From the viewpoint of a radical operation, it would be more appropriate to perform an en bloc complete caudate lobectomy. 5,6 In this sense, a combined resection of the overlying liver parenchyma is thus considered to contribute little to the radicality of the resection. Nagasue et al 13 have reported the long-term survival rate after a resection in patients with recurrent caudate HCC to be much poorer in comparison to those patients with primary caudate HCC because of the frequent recurrence in the former group.…”

Section: Discussionmentioning

confidence: 99%

“…1 Owing to the precise anatomical knowledge of the caudate lobe and the recent descriptions of the surgical techniques for performing a caudate lobectomy, successful surgical resections of the caudate tumors in patients, not only with a normal liver, but also with a diseased liver, have been reported. [2][3][4][5][6][7] However, the optimal surgical approach to caudate HCC in patients with cirrhosis remains to be elucidated. Moreover, the optimal operative procedures in the patients with recurrent HCC developing in the caudate lobe remain to be clarifi ed.…”

Section: Introductionmentioning

confidence: 99%

High dorsal resection for recurrent hepatocellular carcinoma originating in the caudate lobe

et al. 2009

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Standards that enable surgeons to balance radical operative procedures with functional preservation for recurrent hepatocellular carcinoma (HCC) in the caudate lobe have not yet been established. A 54-year-old man with recurrent HCC originating in the caudate lobe was readmitted to our hospital. The combined resection of the adjacent hepatic parenchyma may have carried a risk of postoperative liver failure. The anterior transhepatic approach may have caused massive bleeding due to the presence of scarring from the previous hepatectomy. Therefore, we performed an isolated total caudate lobectomy, i.e., a "high dorsal resection" as a second hepatectomy. The postoperative course of the patient was uneventful, and there has been no local recurrence 1 year after the repeat hepatectomy. Indeed a "high dorsal resection" is rarely required, but it is still ingenious, and this surgical modality can balance the curability with the hepatic functional reserve even for recurrent caudate HCC in patients with liver cirrhosis.

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“…Left side approach is adopted for small lesions in the lower part of the Spiegel lobe and right side approach for small lesions in the caudate process. Combined left and right sides approach is recommended for the majority of neoplasms in the caudate lobe [5, 9], especially for those that are bigger than 4 cm in diameter, those originating in the paracaval portion or in the whole caudate lobe, or those that are thought to be malignant tumors, which require total caudate lobectomy for clearance of the tumors. Symptomatic and continuously enlarging hepatic cavernous hemangioma also requires total caudate lobectomy before it reaches a nonresectable size.…”

Section: Discussionmentioning

confidence: 99%

“…Dissection and division of the short hepatic veins are the major difficulty in isolated caudate lobectomy [9]. Complete mobilization of the liver is essential.…”

Section: Discussionmentioning

confidence: 99%

Surgical Strategy for Isolated Caudate Lobectomy: Experience with 16 Cases

et al. 2014

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Introduction. Surgical resection is the most effective treatment for neoplasm in the caudate lobe. Isolated caudate lobectomy is still a challenge for hepatobiliary surgeons. No widely accepted surgical strategy for the procedure has been developed yet. Objective. To get a better understanding of isolated caudate lobectomy and to optimize the procedure. Materials and Methods. 16 cases of isolated caudate lobectomy were reviewed to summarize the surgical experience. Results. All the 16 cases of isolated caudate lobectomy were carried out successfully, among which left side approach was adopted in two cases (12.5%), right side approach in three cases (18.75%), and both sides approach in 11 cases (68.75%). No severe complications occurred. Conclusion. The majority of neoplasms confined to the caudate lobe can be resected safely by left and right side approach with proper anatomic surgical procedure, usually in the sequence of mobilization, outflow control, inflow control, and division of the hepatic parenchyma. Fully mobilizing the caudate lobe from the inferior vena cava (IVC) is of great importance. Division of the retrohepatic ligament and the venous ligament facilitated the procedure.

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Caudate lobectomy: tumor location, topographic classification, and technique using right- and left-sided approaches to the liver

Cited by 38 publications

References 15 publications

Caudate lobe resection: an Egyptian center experience

Caudate lobe resection: an Egyptian center experience

High dorsal resection for recurrent hepatocellular carcinoma originating in the caudate lobe

Surgical Strategy for Isolated Caudate Lobectomy: Experience with 16 Cases

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