title: Caudate lobectomy (segmentectomy 1) (with video).
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Midorikawa
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D004210:Dissection / Q000379:methods; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000601:surgery*; D006801:Humans; D007813:Laparotomy; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D013908:Thoracotomy; D014682:Vena Cava, Inferior / Q000601:surgery*