title: A Left-Sided Approach for Resection of Hepatic Caudate Lobe Hemangioma: Two Case Reports and a Literature Review.
abstract: Resection of the hemangioma located in the caudate lobe is a major challenge in current liver surgery. This study aimed to present our surgical technique for this condition. Two consecutive patients with symptomatic hepatic hemangioma undergoing caudate lobectomy were investigated retrospectively. First, all the blood inflow of hemangioma from the portal vein and the hepatic artery at the base of the umbilical fissure was dissected. After the tumors became soft and tender, the short hepatic veins and the ligaments between the secondary porta hepatis were severed. At last the tumors were resected from the right lobe of the liver. The whole process was finished by a left-sided approach. Blood lost in Case 1 was 1650 mL because of ligature failing in one short hepatic vein, and in the other case, 210 mL. Operation time was 236 minutes and 130 minutes, respectively. Postoperative hospital stays were 11 and 5 days, respectively. The diameter of tumors was 9.0 cm and 6.5 cm. Case 1 required blood transfusion during surgery. No complications such as biliary fistula, postoperative bleeding, and liver failure occurred. The left-sided approach produced the best results for caudate lobe resection in our cases. The patients who recovered are living well and asymptomatic. Caudate lobectomy can be performed safely and quickly by a left-sided approach, which is carried out with optimized perioperative management and innovative surgical technique.
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China.
authors.forename: Xielin
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Hu
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China.
authors.forename: Junping
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China.
authors.forename: Aixiang
authors.initials: A
authors.lastname: Liu
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China.
authors.forename: Lang
authors.initials: L
authors.lastname: Tian
authors.affiliation: Department of Hepatopancreatobiliary Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D005260:Female; D006391:Hemangioma / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000601:surgery*; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies
keywords: Caudate lobe; Hemangioma; Left-sided approach hepatectomy; Surgical technique