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Anterior Hepatic Parenchymal Transection for Complete Caudate Lobectomy to Treat Liver Cancer Situated in or Involving the Paracaval Portion of the Caudate Lobe

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Complete caudate lobectomy using the anterior hepatic parenchymal transection approach is a proper but technically demanding operation for tumors situated in or involving the paracaval portion of the caudate lobe. This study was intended to share our experience on this operation.

Method

Forty-nine consecutive patients who received complete caudate lobectomy using the anterior hepatic parenchymal transection approach were studied. The clinicopathologic and perioperative data, complications, and survival were analyzed.

Results

Of the 49 patients, 15 (30.6 %) received isolated complete caudate lobectomy and 34 (69.4 %) received complete caudate lobectomy associated with segmentectomy IV. The median tumor size was 7.3 cm (2.4–18.0 cm), the operating time was 200 min (120–370 min), and the operative blood loss was 700 ml (200–3000 ml). The postoperative complication rate was 36.7 %. There was no perioperative death. Patients in the associated complete caudate lobectomy group had larger tumors (P < 0.001), higher platelet counts (P = 0.033), shorter operation time (P = 0.004), and less patients with residual tumor (P = 0.03) than those in the isolated complete caudate lobectomy group. There were no significant differences in cirrhosis, surgical resection margin, blood loss, postoperative complications, and prognosis between the two groups.

Conclusion

Complete caudate lobectomy using the anterior hepatic parenchymal transection approach was technically feasible and safe for patients with tumors situated in or involving the paracaval portion of the caudate lobe. Associated resection of segment IV can be used to facilitate the surgery and decrease the chance of local residual tumor.

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Funding

This study was funded by the following: The State Key Infection Diseases Project of China: 2012ZX10002010, 2012ZX10002016; the Science Fund for Creative Research Groups, NSFC, China: 81221061; the National Natural Science Foundation of China: 81372207, 81472285, 81402269, 31201025; and the initiating fund for younger from the Secondary Military Medical University: 2012QN19.

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Authors and Affiliations

  1. The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, No. 225, Changhai Road, Shanghai, 200438, China

    Zhen-Guang Wang, WanYee Lau, Si-Yuan Fu, Hui Liu, Ze-Ya Pan, Yuan Yang, Jin Zhang, Meng-Chao Wu & Wei-Ping Zhou

  2. Faculty of Medicine, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, China

    WanYee Lau

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  1. Zhen-Guang Wang
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  2. WanYee Lau
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  3. Si-Yuan Fu
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  4. Hui Liu
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  5. Ze-Ya Pan
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  6. Yuan Yang
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  7. Jin Zhang
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  8. Meng-Chao Wu
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  9. Wei-Ping Zhou
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Corresponding author

Correspondence to Wei-Ping Zhou.

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Wang, ZG., Lau, W., Fu, SY. et al. Anterior Hepatic Parenchymal Transection for Complete Caudate Lobectomy to Treat Liver Cancer Situated in or Involving the Paracaval Portion of the Caudate Lobe. J Gastrointest Surg 19, 880–886 (2015). https://doi.org/10.1007/s11605-015-2793-4

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  • DOI: https://doi.org/10.1007/s11605-015-2793-4

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