Surgical outcomes of isolated caudate lobe resection: a single series of 19 patients.

Published on Oct 1, 2002in Surgery3.982
· DOI :10.1067/MSY.2002.127691
Juan M. Sarmiento47
Estimated H-index: 47
(Mayo Clinic),
Florencia G. Que52
Estimated H-index: 52
(Mayo Clinic),
David M. Nagorney116
Estimated H-index: 116
(Mayo Clinic)
Sources
Abstract
Abstract Background. Isolated caudate lobe resection is a complex surgical procedure that requires technical expertise and knowledge of the surgical anatomy. Methods. All consecutive patients who were operated on for isolated caudate lobe resections by the senior author were studied. En bloc resections with adjacent hepatic parenchyma (as part of extended hepatectomies) or partial resections of the caudate lobe were excluded. Follow-up was completed by outpatient evaluation and mail correspondence. Results. Nineteen patients met the inclusion criteria (6 male, 13 female). Mean age (±SD) was 52 (±3) years. Primary diagnoses were colorectal metastases, hemangioma, hepatocellular carcinoma, adenoma, and neuroendocrine metastases. Margins were negative in all but 1 patient. One patient needed inferior vena cava resection. Pringle's maneuver was used in 1 patient (5%). Mean (±SD) operative time was 211 (±15) minutes, and estimated blood loss was 760 (±150) mL. Median blood transfusion was 0 U (range, 0-4). Complications (bile leak) were seen in 1 patient (5%). Median length of stay was 7 days (range, 4-14). There were no perioperative deaths. Conclusions. Isolated caudate lobe resection is a feasible procedure that can be done with low morbidity/mortality. Sound surgical judgment and detailed knowledge of the caudate lobe anatomy are keys for a safe performance of this procedure. (Surgery 2002;132:697-709.)
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References22
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#1Jia Fan (Fudan University Shanghai Medical College)H-Index: 24
#2Zhi-Quan WuH-Index: 25
Last. Ye-Qin YuH-Index: 16
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Background/Aims: To study the technique and curative effects of complete resection of the caudate lobe of the liver with tumors. Methodology: There were 18 patients with tumors in the caudate lobe of the liver in this study. Among them, hepatocellular carcinoma was found in 12 patients, metastasis to the caudate lobe two years after resection of rectal carcinoma in one, cholangiocarcinoma in one, and huge benign tumor in four. Complete caudate lobectomy and combined with left lateral lobectomy o...
#1Takeshi TonoH-Index: 12
#2Hiroki OhzatoH-Index: 17
Last. Yuichi TakatsukaH-Index: 19
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Malignant tumor resection of the hepatic caudate lobe has recently received attention. However, there are few reports about metastatic liver tumor in the caudate lobe from colorectal carcinoma, and its clinical features still remain unknown. In this paper, three patients operated on in our institute and 15 reported cases from the published literature were analyzed in order to reveal clinical features of this disease. Many cases had advanced liver tumors, such as invasion in to major vessels at t...
#1Junji YamamotoH-Index: 52
#2Tomoo KosugeH-Index: 86
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: We have devised a new technique for isolated caudate lobe resection in which we access the caudate lobe by separating the liver parenchyma along the interlobar plane. The safety and radicality of the procedure were evaluated in five patients: four with hepatocellular carcinoma (HCC) and one with metastatic rectal cancer. All of the tumors were located mainly in the paracaval portion of the caudate lobe. The patients with HCC (three of four) underwent an anatomic caudate lobe resection by ident...
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#1Tadatoshi Takayama (UTokyo: University of Tokyo)H-Index: 92
#2Makuuchi MH-Index: 1
Background/Aims: Resection of the caudate lobe of the liver is difficult to perform because ofa deep location and an adjacency to the major vessels. Methodology: A total of 30 patients with hepatocellular carcinoma (HCC) originating in the caudate lobe underwent hepatic resection. The lobe was classified to Spiegel's portion, the process portion, and the caval portion. The operative procedure undertaken was chosen on the basis of tumor location as well as hepatic function of each patient. Result...
BACKGROUND: Resection of the caudate lobe of the liver to treat malignancies has recently received attention, but long-term results after such resection for hepatocellular carcinoma have not been reported for an acceptable number of patients. This study analyzed the short- and long-term results after resection of the caudate lobe for primary and recurrent hepatocellular carcinoma in 19 patients. STUDY DESIGN: Complete or partial resection of the caudate lobe was performed for the treatment of pr...
#1Marcel Cerqueira César Machado (USP: University of São Paulo)H-Index: 18
#2Paulo HermanH-Index: 26
Last. H W PinottiH-Index: 11
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Liver tumors rarely arise in the caudate lobe and resection of such tumors is even more rare. Spigel's lobe resection, first described by Ton Thac Tung, is a very unusual operation and the technique has not been clearly established. Recently, successful resections of the caudate lobe of the liver have been reported. Since Edmonson's first report in 1956, fibrolamellar carcinoma of the liver (FLC) has been recognized as α distinct variant of hepatocellular carcinoma. It occurs, without sexual pre...
#1Yuji Nimura (Nagoya University)H-Index: 89
#2Naokazu Hayakawa (Nagoya University)H-Index: 37
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We have studied the surgical anatomy of the intrahepatic bile duct, hepatic hilus, and caudate lobe based on intraoperative findings and selective cholangiography of surgical patients and resected specimens, and have established the cholangiographic anatomy of the intrahepatic subsegmental bile duct. Thorough knowledge of the three-dimensional anatomy of the subsegmental bile duct, hepatic hilus, and caudate lobe is indispensable for curative surgery of hilar cholangiocarcinoma. We designed and ...
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#1Katsuhiko Yanaga (Kyushu University)H-Index: 63
#2Takashi MatsumataH-Index: 45
Last. K. SugimachiH-Index: 65
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Abstract Isolated caudate lobectomy is a challenging surgical procedure for which safe and reliable techniques have yet to be developed. Isolated caudate lobectomy was performed by initial inflow control of the caudate lobe, full mobilization of the liver from the inferior vena cava by dividing all short hepatic veins, and parenchymal division dorsal to the major hepatic veins with a clockwise rotation of the liver while the liver was selectively devascularized by Pringle's maneuver and occlusio...
#1Mitsuo Shimada (Kyushu University)H-Index: 91
#2Takashi Matsumata (Kyushu University)H-Index: 45
Last. Keizo Sugimachi (Kyushu University)H-Index: 114
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Nine patients with hepatocellular carcinoma originating in the caudate lobe who underwent hepatic resection were studied. The caudate lobe was divided into three parts, according to the criteria of Kumon, including the Spiegel lobe, the paracaval portion and the caudate process. The tumors were located in the Spiegel lobe in four, the paracaval portion in four and the caudate process in one. Surgical procedures consisted of right hepatic lobectomy in one, central bisegmentectomy in one and cauda...
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#1Tomoo KosugeH-Index: 86
#2Junji YamamotoH-Index: 44
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An isolated resection of the entire caudate lobe, including the paracaval portion, was performed in a 68-year-old man with hepatocellular carcinoma complicated by chronic hepatitis. Precise resection of the paracaval portion, which surrounds the right side of the inferior vena cava, is difficult because of its deep location and the lack of superficial landmarks indicating its margins. Using a counterstaining technique to define the right margin and the transhepatic anterior approach to access th...
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OBJECTIVE: To propose an algorithm for resecting hepatocellular carcinoma (HCC) in the caudate lobe. BACKGROUND: Owing to a deep location, resection of HCC originating in the caudate lobe is challenging, but a plausible guideline enabling safe, curable resection remains unknown. METHODS: We developed an algorithm based on sublocation or size of the tumor and liver function to guide the optimal procedure for resecting HCC in the caudate lobe, consisting of 3 portions (Spiegel, process, and caval)...
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#1Tamas BenköH-Index: 7
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Objective The venous vascular anatomy of the caudate lobe is exceptional. The purpose of this study was to assess portal inflow and venous outflow volumes of the caudate lobe.
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Abstract Introduction The caudate lobe is a distinct liver lobe and surgical resection requires expertise and precise anatomic knowledge. Left-sided approach was described for resection of small tumors originated in the Spiegel lobe but now the procedure has been performed even for tumors more than five centimeters. The aim of this study is to present three cases of tumor of caudate lobe underwent isolated lobectomy by left-sided approach. Presentation of case Three patients with metastasis of c...
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#1Toshiya Ochiai (Kyoto Prefectural University of Medicine)H-Index: 25
#2Hiromichi Ishii (Kyoto Prefectural University of Medicine)H-Index: 7
Last. Eigo Otsuji (Kyoto Prefectural University of Medicine)H-Index: 59
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Background Isolated anatomic total caudate lobectomy is indicated in patients who have liver tumors limited to the caudate lobe. However, isolated caudate lobe resection is a challenging surgical procedure that required safe and reliable techniques. All portal and hepatic veins that connect this area originate from the first branch of the portal vein or vena cava; therefore, the operator must be cautious of the potential for massive bleeding.
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#1Luca Viganò (Humanitas University)H-Index: 37
#2Guido Costa (Humanitas University)H-Index: 15
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#1Serdar Topaloglu (Karadeniz Technical University)H-Index: 11
#2Sukru OguzH-Index: 8
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RESULTS A total of 19 enucleations and six anatomic resections were performed. Operative time, intraoperative bleeding amount, Pringle period, and blood transfusion were comparable between the two groups (P > 0.05, for all). The perioperative serum aspartate transaminase level was not different between groups (P = 1.000). Perioperative total bilirubin levels were significantly increased in the PSIAE group (P = 0.041). Postoperative hospital stay was longer in the PSIAE group. Surgical complicati...
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#1Gustavo Martínez-Mier (Mexican Social Security Institute)H-Index: 10
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Resumen Antecedentes El hepatocarcinoma originado en el lobulo caudado tiene un peor pronostico que otros originados en otros sitios del higado. La reseccion aislada del lobulo caudado hepatico representa un reto tecnico importante y puede ser realizada junto con una lobectomia hepatica o una reseccion aislada del mismo. De esta ultima existen muy pocos reportes al respecto. Presentamos el caso de una reseccion aislada exitosa de hepatocarcinoma en el lobulo caudado con sobrevida a largo plazo. ...
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#1Gustavo Martínez-Mier (Mexican Social Security Institute)H-Index: 10
#2S. Esquivel-Torres (Mexican Social Security Institute)H-Index: 2
Last. P Grube-Pagola (Mexican Social Security Institute)H-Index: 3
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Abstract Background Hepatocellular carcinoma originating from the caudate lobe has a worse prognosis than other hepatocellular carcinomas in another segment of the liver. An isolated caudate lobe resection of the liver represents a significant technical challenge. Caudate lobe resection can be performed along with a lobectomy, or as an isolated liver resection. There are very few reports about isolated caudate lobe liver resection. The case is reported here of a successful isolated resection of ...
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#1Wei-Dong Dai (CSU: Central South University)H-Index: 6
: Isolated caudate lobectomy for huge hepatocellular carcinoma (HCC) (10 cm or greater in diameter) is a technically demanding surgical procedure that entails the surgeon's experience and precise anatomical knowledge of the liver. We describe our clinical experiences and evaluate the results of partial or total isolated caudate lobectomy for HCC larger than 10 cm in the caudate lobe. En bloc excisions combined with adjacent hepatic parenchyma (as part of extended hepatectomies) were excluded. Tw...
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