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Caudate lobectomy (segmentectomy 1) (with video)

  • Topics
  • Highly advanced surgery in the hepatobiliary and pancreatic field (Liver Section)
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Journal of Hepato-Biliary-Pancreatic Sciences



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.


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.


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.

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  1. Couinaud C. Posterior or dorsal liver. In: Couinaud C (ed.) Surgical anatomy of the liver revisited. 1989. p. 123–34.

  2. Takayama T, Makuuchi M, Kosuge T, et al. A hepatoblastoma originating in the caudate lobe radically resected with the inferior vena cava. Surgery. 1991;109:208–13.

    PubMed  CAS  Google Scholar 

  3. Takayama T, Tanaka T, Higaki T, et al. High dorsal resection of the liver. J Am Coll Surg. 1994;179:72–5.

    PubMed  CAS  Google Scholar 

  4. Yamamoto J, Takayama T, Kosuge T, et al. An isolated caudate lobectomy by the transhepatic approach for hepatocellular carcinoma in cirrhotic liver. Surgery. 1992;111:699–702.

    PubMed  CAS  Google Scholar 

  5. Kumon M. Portal vein and bile duct branches of the caudate lobe; analysis of liver cast and clinical cases (in Japanese). Kanzou (Acta Hepatol Jpn). 1985;26:1193–9.

    Article  Google Scholar 

  6. Makuuchi M, Kosuge T, Takayama T, et al. Surgery for small liver cancers. Semin Surg Oncol. 1993;9:298–304.

    Article  PubMed  CAS  Google Scholar 

  7. Takayama T, Makuuchi M, Watanabe K, et al. A new method for mapping hepatic subsegment: counterstaining identification technique. Surgery. 1991;109:226–9.

    PubMed  CAS  Google Scholar 

  8. Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy. Surg Gynecol Obstet. 1985;161:346–50.

    PubMed  CAS  Google Scholar 

  9. Yanaga K, Matsumata T, Hayashi H, et al. Isolated hepatic caudate lobectomy. Surgery. 1994;115:757–61.

    PubMed  CAS  Google Scholar 

  10. Yamamoto J, Kosuge T, Shimada K, et al. Anterior transhepatic approach for isolated resection of the caudate lobe of the liver. World J Surg. 1999;23:97–101.

    Article  PubMed  CAS  Google Scholar 

  11. Takayama T, Makuuchi M. Segmental liver resections, present and future-caudate lobe resection for liver tumors. Hepatogastroenterology. 1998;45:20–3.

    PubMed  CAS  Google Scholar 

  12. Ishizawa T, Hasegawa K, Ikeda M, et al. Transhepatic approach for a small paracaval tumor in repeat resection. Dig Surg. 2007;24:409–12.

    Article  PubMed  Google Scholar 

  13. Takayama T. High dorsal resection of the liver. Visual Lectures on Cancer Operations in Japan: Tokyo; 2009. p. 429–50.

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

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The authors declare that they have no conflict of interest.

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Correspondence to Tadatoshi Takayama.

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Midorikawa, Y., Takayama, T. Caudate lobectomy (segmentectomy 1) (with video). J Hepatobiliary Pancreat Sci 19, 48–53 (2012).

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