Isolated caudate lobe resection: technical challenges.
BACKGROUND
Isolated caudate lobe resection remains a technical challenge even in the best hands. This is due to the difficult approach and its location between major vessels. This retrospective study aims to analyze our experience with isolated caudate lobe resections.


METHODS
Of the 402 patients who underwent liver resections between January 2002 and December 2011, we identified 13 caudate lobectomies. We analyzed the operative parameters, hospital stay, morbidity and follow up of these patients.


RESULTS
There were nine males and four females, age ranging between 30 and 72 years. The indications were hepatocellular carcinoma in nine patients, hilar cholangiocarcinoma in two, solitary fibrous tumor in one, and a regenerative nodule in one patient. Left-sided approach was employed in seven cases, right-sided approach in three cases and a combined approach in three cases. Operating time ranged between 125 and 225 min and blood loss ranged between 210 and 630 mL. There was no mortality in the post-operative period. No local recurrence was noted in the follow-up period ranging from 6 months to 7 years.


CONCLUSIONS
Caudate lobe resections, although technically challenging, can be successfully performed with minimal blood loss. Surgery offers potential cure in isolated caudate lobe tumors. The location and size of the tumor decides the approach.
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Sastha
S
Ahanatha Pillai
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Jeswanth
J
Sathyanesan
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Senthilkumar
S
Perumal
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Srinivasan
S
Ulagendra Perumal
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Anand
A
Lakshmanan
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Sukumar
S
Ramaswami
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Ravi
R
Ramasamy
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Ravichandran
R
Palaniappan
Institute of Surgical Gastroenterology and Liver Transplantation, Government Stanley Medical College, Chennai, India.
Surendran
S
Rajagopal
Caudate lobe tumors; hepatocellular carcinoma; hilar cholangiocarcinoma; isolated caudate lobe resection