Isolated caudate lobe resection for hepatic tumor: surgical approaches and perioperative outcomes

Abstract 

Background

Caudate lobe of the liver is relatively inaccessible because of its deep location and lying between the major vascular structures. Therefore, isolated caudate lobe resection (ICLR) is a much challengeable operation.

Methods

Review of prospectively collected data from patients who underwent ICLR for hepatic tumor.

Results

Forty-six patients (mean age 46.8 years) underwent ICLR for malignant (39 cases) and benign (7 cases) hepatic tumors. ICLRs were performed by 3 different approaches and in different ways of hepatic vascular control: without any vascular control in 7 patients, under Pringle maneuver in 26 patients, and under sequential inflow and outflow vascular occlusion in 13 patients. There were no perioperative deaths, and the postoperative complication rate was 8.7% (4/46). The mean operative time was 174.5 ± 44.3 minutes and the mean estimated intraoperative blood loss was 504.4 ± 356.2 mL.

Conclusions

ICLR is a technically demanding but safe procedure. Choice of surgical approaches and ways of hepatic vascular control should be based on tumor location and surgeons'experience.

Keywords: Hepatectomy, Liver Neoplasms, Caudate Lobe