title: Improved anterior hepatic transection for isolated hepatocellular carcinoma in the caudate.
abstract: BACKGROUND
  One of the best treatments for isolated hepatocellular carcinoma in the caudate lobe is major hepatectomy with caudate lobectomy, but it is not suitable for patients with poor liver function reserve. Isolated caudate lobectomy, which is a very difficult operation, is thus an alternative option.
  
  
  METHODS
  Here we report an isolated caudate lobectomy with an anterior approach in the treatment of a large hepatocellular carcinoma with underlying cirrhosis, with focus on the technical aspects.
  
  
  RESULTS
  In the operation, both the left and right lobes of the liver were mobilized. Hepatotomy was done along the round ligament where parenchymal transection was minimal. After exposure of the left and middle hepatic veins and the hilar plate, the caudate lobe and the tumor were resected en bloc with a 5-mm margin.
  
  
  CONCLUSIONS
  Isolated caudate lobectomy can be performed safely with this anterior approach on patients with poor liver function reserve.
authors.affiliation: Department of Surgery, The University of Hong Kong, 102 Pok Fu Lam Road, Hong Kong, China. tantocheung@hotmail.com.
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.forename: Wai Key
authors.initials: WK
authors.lastname: Yuen
authors.forename: Ronnie T P
authors.initials: RT
authors.lastname: Poon
authors.forename: See Ching
authors.initials: SC
authors.lastname: Chan
authors.forename: Sheung Tat
authors.initials: ST
authors.lastname: Fan
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery* / Q000821:virology; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006509:Hepatitis B / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology / Q000821:virology; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome