Central Surgical AssociationSurgical outcomes of isolated caudate lobe resection: A single series of 19 patients*
Section snippets
Methods
We examined the records of all consecutive patients who underwent complete isolated caudate lobe resection by the senior author (D.M.N.) between 1981 and 2000. Patients who had caudate resection en bloc with adjacent hepatic segments or lobes with or without bile duct resections or subsegmental (wedge) resections of the caudate lobe were excluded. Patients with simultaneous resection of other organs or distant hepatic segments (not in continuity) were included. Histopathology was recorded.
Results
From 90 patients who underwent caudate lobe resection during the study period, 19 who underwent isolated resection of the lobe were culled for this analysis. The other 71 patients had caudate lobectomies in continuity with left or right hepatectomy. There was a preponderance of women (n = 13). Mean (±SD) patient age was 52 (±3) years, with a range of 36 to 76 years. Twelve resections were done for colorectal metastases. Other diagnoses included HCC (n = 2), 1 of them with cirrhosis; hemangioma
Discussion
Isolated resection of the caudate lobe has been considered a technically challenging procedure.1 Its position behind the major lobes and its close proximity to the portal triad, hepatic veins, and IVC poses a complex access to this lobe. In major centers, caudate lobe excision comprises only 0.5% to 4% of the total number of hepatic resections3, 7 and isolated excisions of the caudate lobe are even more infrequent. As recently as 1998, only 2 out of 30 patients with HCC located in the caudate
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Reprint requests: David M. Nagorney, MD, Department of Surgery, Mayo Clinic, 200 First St SW, Rochester, MN 55905.