Isolated hepatic caudate lobectomy.
BACKGROUND
Isolated caudate lobectomy is a challenging surgical procedure for which safe and reliable techniques have yet to be developed.


METHODS
Isolated caudate lobectomy was performed by initial inflow control of the caudate lobe, full mobilization of the liver from the inferior vena cava by dividing all short hepatic veins, and parenchymal division dorsal to the major hepatic veins with a clockwise rotation of the liver while the liver was selectively devascularized by Pringle's maneuver and occlusion of the confluence of the major hepatic veins flush with the inferior vena cava.


RESULTS
Two patients with cirrhosis underwent this procedure successfully without intraoperative hemodynamic instability or postoperative liver dysfunction.


CONCLUSIONS
This technique allows safe and truly selective excision of the caudate lobe without the need for occlusion of the inferior vena cava or venovenous bypass.
Yanaga
K
K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Matsumata
T
T
Hayashi
H
H
Shimada
M
M
Urata
K
K
Sugimachi
K
K
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery; D006801:Humans; D008099:Liver / Q000033:anatomy & histology / Q000098:blood supply; D008103:Liver Cirrhosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed