Journal of Gastrointestinal Surgery

, Volume 17, Issue 3, pp 522–526 | Cite as

Laparoscopic Caudate Hepatectomy for Cancer—An Innovative Approach to the No-Man’s Land

  • Kuo-Hsin Chen
  • Kuo-Shyang Jeng
  • Shih-Horng Huang
  • Shu-Hsun Chu
Original Article

Abstract

Background

Caudate hepatectomy remains a surgical challenge in spite of recent advances in laparoscopic technique. Hepatic tumor in the caudate lobe is usually deeply located in the center of the liver and close to the vena cava and hepatic hilum. Thus, lesion in this region was considered as a contraindication of laparoscopic hepatectomy. Only sporadic reports could be found in the literature. The aim of this study is to review the safety and feasibility of laparoscopic hepatectomy for lesions in the caudate lobe.

Methods

Nine consecutive patients with caudate hepatic tumor received laparoscopic caudate hepatectomy in our institute from February 2006 to July 2010. One patient with hepatic adenoma was excluded from the analysis. Demographic data, intraoperative parameters, and postoperative outcomes of the remaining eight patients were assessed.

Results

All procedure for these eight patients with caudate hepatic tumors (size 0.9–4.5 cm) were completed with totally laparoscopic technique except one in which additional left hepatectomy was also done. The average operative time was 254 min (range 210–345 min) and estimated blood loss was 202 ml (range 10–1,000 ml), and average length of postoperative hospital stay was 6.9 days (range 4–11 days). There was no perioperative complications and patient mortality in this series.

Conclusions

Our experience demonstrated that laparoscopic hepatectomy is a safe and feasible procedure for caudate hepatic tumors in selected patients.

Keywords

Hepatectomy Laparoscopy Hepatocellular carcinoma Caudate Metastasis 

Notes

Conflict of Interest

The authors listed have no conflicts of interest or financial ties to disclose.

References

  1. 1.
    Buell JF, Cherqui D, Geller DA, O'Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D'Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS; World Consensus Conference on Laparoscopic Surgery. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg. 2009;250:825–30PubMedCrossRefGoogle Scholar
  2. 2.
    Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009;250:831–41.PubMedCrossRefGoogle Scholar
  3. 3.
    Gagner M, Rheault M, Dubuc J. Laparoscopic partial hepatectomy for liver tumor. Surg Endosc. 1992;6: 99.Google Scholar
  4. 4.
    Buell JF, Thomas MT, Rudich S, Marvin M, Nagubandi R, Ravindra KV, Brock G, McMasters KM. Experience with more than 500 minimally invasive hepatic procedures. Ann Surg. 2008;248:475–86PubMedGoogle Scholar
  5. 5.
    Kazaryan AM, Pavlik Marangos I, Rosseland AR, Røsok BI, Mala T, Villanger O, Mathisen O, Giercksky KE, Edwin B. Laparoscopic liver resection for malignant and benign lesions: ten-year Norwegian single-center experience. Arch Surg. 2010;145:34–40.PubMedCrossRefGoogle Scholar
  6. 6.
    Cherqui D, Laurent A, Tayar C, Chang S, Van Nhieu JT, Loriau J, Karoui M, Duvoux C, Dhumeaux D, Fagniez PL. Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann Surg. 2006;243:499–506.PubMedCrossRefGoogle Scholar
  7. 7.
    Chang S, Laurent A, Tayar C, Karoui M, Cherqui D. Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg. 2007;94:58–63.PubMedCrossRefGoogle Scholar
  8. 8.
    Samama G, Chiche L, Bre´fort JL, Le Roux Y. Laparoscopic anatomical hepatic resection. Report of four left lobectomies for solid tumors. Surg Endosc. 1998;12:76–8.PubMedCrossRefGoogle Scholar
  9. 9.
    Nitta H, Sasaki A, Fujita T, Itabashi H, Hoshikawa K, Takahara T, Takahashi M, Nishizuka S, Wakabayashi G. Laparoscopy-assisted major liver resections employing a hanging technique: the original procedure. Ann Surg. 2010 ;251:450–3.PubMedCrossRefGoogle Scholar
  10. 10.
    Dagher I, O'Rourke N, Geller DA, Cherqui D, Belli G, Gamblin TC, Lainas P, Laurent A, Nguyen KT, Marvin MR, Thomas M, Ravindra K, Fielding G, Franco D, Buell JF. Laparoscopic major hepatectomy: an evolution in standard of care. Ann Surg. 2009;250:856–60.PubMedCrossRefGoogle Scholar
  11. 11.
    Di Giuro G, Lainas P, Franco D, Dagher I. Laparoscopic left hepatectomy with prior vascular control. Surg Endosc. 2010;24:697–9.PubMedCrossRefGoogle Scholar
  12. 12.
    Zhang L, Chen YJ, Shang CZ, Zhang HW, Huang ZJ. Total laparoscopic liver resection in 78 patients. World J Gastroenterol. 2009;15:5727–31.PubMedCrossRefGoogle Scholar
  13. 13.
    Polignano FM, Quyn AJ, de Figueiredo RS, Henderson NA, Kulli C, Tait IS. Laparoscopic versus open liver segmentectomy: prospective, case-matched, intention-to-treat analysis of clinical outcomes and cost effectiveness. Surg Endosc. 2008 ;22:2564–70.PubMedCrossRefGoogle Scholar
  14. 14.
    Ito K, Ito H, Are C, Allen PJ, Fong Y, DeMatteo RP, Jarnagin WR, D'Angelica MI. Laparoscopic versus open liver resection: a matched-pair case control study. J Gastrointest Surg. 2009;13:2276–83.PubMedCrossRefGoogle Scholar
  15. 15.
    Rowe AJ, Meneghetti AT, Schumacher PA, Buczkowski AK, Scudamore CH, Panton ON, Chung SW. Perioperative analysis of laparoscopic versus open liver resection. Surg Endosc. 2009;23:1198–203.PubMedCrossRefGoogle Scholar
  16. 16.
    Tsinberg M, Tellioglu G, Simpfendorfer CH, Walsh RM, Vogt D, Fung J, Berber E. Comparison of laparoscopic versus open liver tumor resection: a case-controlled study. Surg Endosc. 2009;23:847–53.PubMedCrossRefGoogle Scholar
  17. 17.
    Chen HY, Juan CC, Ker CG. Laparoscopic liver surgery for patients with hepatocellular carcinoma. Ann Surg Oncol. 2008;15:800–6.PubMedCrossRefGoogle Scholar
  18. 18.
    D'Angelica M, Fong Y, Weber S, Gonen M, DeMatteo RP, Conlon K, Blumgart LH, Jarnagin WR. The role of staging laparoscopy in hepatobiliary malignancy: prospective analysis of 401 cases. Ann Surg Oncol. 2003;10:183–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Castaing D, Vibert E, Ricca L, Azoulay D, Adam R, Gayet B.Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers. Ann Surg. 2009;250:849–55.PubMedCrossRefGoogle Scholar
  20. 20.
    Nagasue N, Kohno H, Yamanoi A, Uchida M, Yamaguchi M, Tachibana M, Kubota H, Ohmori H. Resection of the caudate lobe of the liver for primary and recurrent hepatocellular carcinomas. J Am Coll Surg 1997;184:75–76.Google Scholar
  21. 21.
    Hawkins WG, DeMatteo RP, Cohen MS, Jarnagin WR, Fong Y, D'Angelica M, Gonen M, Blumgart LH. Caudate hepatectomy for cancer: a single institution experience with 150 patients. J Am Coll Surg. 2005;200:345–52.PubMedCrossRefGoogle Scholar
  22. 22.
    Dulucq JL, Wintringer P, Stabilini C, Mahajna A. Isolated laparoscopic resection of the hepatic caudate lobe: surgical technique and a report of 2 cases. Surg Laparosc Endosc Percutan Tech. 2006;16:32–5.PubMedCrossRefGoogle Scholar

Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Kuo-Hsin Chen
    • 1
  • Kuo-Shyang Jeng
    • 1
  • Shih-Horng Huang
    • 1
  • Shu-Hsun Chu
    • 2
  1. 1.Department of SurgeryFar Eastern Memorial HospitalBan CiaoTaiwan
  2. 2.Cardiovascular CenterFar Eastern Memorial HospitalBan CiaoTaiwan

Personalised recommendations