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Journal of Hepato-Biliary-Pancreatic Sciences

, Volume 19, Issue 1, pp 48–53 | Cite as

Caudate lobectomy (segmentectomy 1) (with video)

  • Yutaka Midorikawa
  • Tadatoshi TakayamaEmail author
Topics Highly advanced surgery in the hepatobiliary and pancreatic field (Liver Section)

Abstract

Background

The caudate lobe of the liver is located behind both major lobes and is surrounded by the inferior vena cava, three main hepatic veins, and the hepatic hilum. Despite a hard-to-approach anatomic location, isolated complete removal of the caudate lobe is recommended to improve curability in hepatocellular carcinoma (HCC). This is because most patients with HCC cannot undergo caudate lobectomy (segmentectomy 1) with resection of adjacent liver regions due to their poor liver function.

Methods

We performed an anatomic isolated caudate lobectomy using a high dorsal resection technique in patients with HCC involving the paracaval portion of the liver. In this procedure, the caudate lobe is dissected, the boundary of the caudate lobe is identified using counterstaining and tattooing techniques, and the liver is transected along landmarks. The caudate lobe can be removed completely, without loss of the parenchyma of the major lobes, thereby preserving liver function.

Conclusions

Given that most patients with HCC concurrently have chronic liver disease, those with HCC in the caudate lobe are good candidates for high dorsal resection of the liver, which is safe, potentially curative procedure.

Keywords

High dorsal resection of the liver Isolated caudate lobectomy Liver function 

Notes

Acknowledgments

We thank Dr. Hisashi Nakayama for creation of the video.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

Supplementary material 1 (MPG 48136 kb)

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Copyright information

© Japanese Society of Hepato-Biliary-Pancreatic Surgery and Springer 2011

Authors and Affiliations

  1. 1.Department of Digestive SurgeryNihon University School of MedicineTokyoJapan

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