Retrograde Resection of Caudate Lobe

Abstract

The technical approach of conventional caudate lobectomy, as described by Lerut, Colonna, Nagasue and their colleagues (Lerut et al., 1990; Schwartz, 1997; Nagasue et al., 1997), emphasizes the importance of proceeding by dividing the vascular attachments from the lobe to the IVC as the first step, and following this with parenchymal transection. In the procedure of this classic approach, SHVs originating in the caudate lobe are divided and ligated at the initial stage. But when the caudate neoplasm is closely adherent to or infiltrating the IVC, or is too big to be turned from side to side, which precludes dissection of the SHVs, this technique is not suitable for conventional caudate lobectomy. We design and use a technique, retrograde caudate lobectomy, in which division and ligation of the SHVs are carried out at the final stage of the operation instead of at the initial stage. This has proven to be of great help on such occasions.

Abridged from Peng SY, Liu YB, Wang JW, et al. (2008) Retrograde resection of caudate lobe of liver. J Am Coll Surg 206: 1232–1238. Used with permission from Elsevier