Isolated complete caudate lobectomy for hepatic tumor of the anterior transhepatic approach: surgical approaches and perioperative outcomes.
BACKGROUND
How to resect the caudate lobe safely is a major challenge to current liver surgery which requires further study.


METHODS
Nine cases (6 hepatic cell carcinoma, 2 cavernous hemangioma and 1 intrahepatic cholangiocacinoma) were performed using the anterior transhepatic approach in the isolated complete caudate lobe resection. During the operation, we used the following techniques: the intraoperative routine use of Peng's multifunction operative dissector (PMOD), inflow and outflow of hepatic blood control, low central venous pressure and selective use of liver hanging maneuver.


RESULTS
There were no perioperative deaths observed after the operation. The median operating time was 230 ± 43.6 minutes, the median intraoperative blood loss was 606.6 ± 266.3 ml and the median length of postoperative hospital stay was 12.6 ± 2.9 days. The incidence of complications was 22.22% (2/9).


CONCLUSIONS
PMOD and "curettage and aspiration" technique can be of great help of in the dissection of vessels and parenchyma, clearly making caudate lobe resection safer, easier and faster.
Department of General Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai 200092, China. liuybphd@126.com.
Jia-Hua
JH
Yang
Jun
J
Gu
Ping
P
Dong
Lei
L
Chen
Wen-Guang
WG
Wu
Jia-Sheng
JS
Mu
Mao-Lan
ML
Li
Xiang-Song
XS
Wu
Yang-Lu
YL
Zhao
Lin
L
Zhang
Hao
H
Weng
Qian
Q
Ding
Qi-Chen
QC
Ding
Ying-Bin
YB
Liu
D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000473:pathology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome