Related Experiment Video
Updated: Jul 4, 2026
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
Caudate lobectomy: tumor location, topographic classification, and technique using right- and left-sided approaches
Eleazar Chaib1, Marcelo Augusto F Ribeiro, Francisco de S Collet Silva
1Liver and Portal Hypertension Surgery Unit, Department of Gastroenterology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil. eleazarchaib@yahoo.co.uk
Insights
Caudate lobectomy, the removal of a liver section, is technically challenging due to its location. Surgical approach selection for caudate lobe resection depends on tumor specifics and patient factors.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Liver Anatomy
Background:
- Caudate lobe resection (segments I and IX) is technically difficult due to deep location and proximity to major hepatic vessels.
- Challenges include accessing the dorsal sector and right paracaval region of the liver.
Purpose of the Study:
- To review literature on caudate lobectomy techniques.
- To describe right and left-sided surgical approaches for caudate resection.
- To correlate approaches with tumor location and liver anatomy.
Main Methods:
- Literature review of Medline-indexed articles (1990-2005).
- Analysis of 377 caudate lobectomies.
- Classification of surgical approaches based on tumor location.
Main Results:
- The left-sided approach was used in 14.58%, right-sided in 6.36%, and combined approaches in 79.04% of cases.
- Resection included primary benign/malignant and secondary liver tumors.
- Tumor location and topographic classification guided approach selection.
Conclusions:
- Caudate lobe access and resection strategy should be guided by tumor location and patient's hepatic function.
- Left or right approaches are suitable for Spiegel's or process portion tumors.
- Surgical approach depends on lesion size, location, associated resections, and prior scarring.
Background:
Resection of the caudate lobe (involving segments I [dorsal sector] and/or IX [right paracaval region]) often presents a technical challenge. It is difficult to perform because of its deep location and adjacency to the major hepatic vessels (ie, the left and middle hepatic veins).
Methods:
A literature review was performed based on a Medline search to identify articles on caudate lobectomy published from 1990 to 2005. This article describes the right and left-sided approaches to the liver for caudate resection according to caudate lobe tumor location and topographic classification.
Results:
The results of 377 lobectomies were analyzed in this review. The left-sided approach to the liver was used in 55 (14.58%), the right-sided approach in 24 (6.36%), and both approaches in 298 (79.04%) caudate lobectomies. Primary benign and malign liver tumors, as well as secondary liver tumors, were resected.
Conclusions:
Access to and resection of the caudate lobe should be determined on the basis of tumor location and hepatic function. The left or right approach to the caudate lobe can be recommended for local resection of tumor located at Spiegel's portion or process portion. Approaches to caudate lobectomy are therefore largely dependent on size and location of the lesion, type of associated resection, and presence of scarring from previous resection.
