Related Experiment Video
Updated: Jun 20, 2026
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
High dorsal resection for recurrent hepatocellular carcinoma originating in the caudate lobe
Tohru Utsunomiya1, Masahiro Okamoto, Eiji Tsujita
1Department of Surgery, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital, Hiroshima, Japan.
Insights
For recurrent liver cancer in the caudate lobe, surgeons can use a "high dorsal resection" to remove the tumor while preserving liver function. This technique offers a viable option for complex cases, even in patients with cirrhosis.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Liver transplantation
Background:
- Recurrent hepatocellular carcinoma (HCC) in the caudate lobe presents unique surgical challenges.
- Established standards for balancing radical resection with functional preservation in recurrent caudate HCC are lacking.
- Previous surgeries and liver cirrhosis can complicate re-hepatectomy for caudate lobe tumors.
Observation:
- A 54-year-old male patient with recurrent HCC in the caudate lobe underwent a second hepatectomy.
- Standard approaches carried risks of liver failure and bleeding due to prior surgery and tumor location.
- An isolated total caudate lobectomy, termed "high dorsal resection," was performed.
Findings:
- The
- high dorsal resection
- procedure was successfully performed as a second hepatectomy.
- The patient experienced an uneventful postoperative recovery.
- No local recurrence was observed 1 year after the repeat hepatectomy.
Implications:
- This surgical approach, though rarely needed, can effectively treat recurrent caudate HCC.
- It allows for radical tumor removal while maintaining adequate hepatic functional reserve.
- This technique is a valuable option for patients with liver cirrhosis and recurrent caudate lobe tumors.
Abstract:
Standards that enable surgeons to balance radical operative procedures with functional preservation for recurrent hepatocellular carcinoma (HCC) in the caudate lobe have not yet been established. A 54-year-old man with recurrent HCC originating in the caudate lobe was readmitted to our hospital. The combined resection of the adjacent hepatic parenchyma may have carried a risk of postoperative liver failure. The anterior transhepatic approach may have caused massive bleeding due to the presence of scarring from the previous hepatectomy. Therefore, we performed an isolated total caudate lobectomy, i.e., a "high dorsal resection" as a second hepatectomy. The postoperative course of the patient was uneventful, and there has been no local recurrence 1 year after the repeat hepatectomy. Indeed a "high dorsal resection" is rarely required, but it is still ingenious, and this surgical modality can balance the curability with the hepatic functional reserve even for recurrent caudate HCC in patients with liver cirrhosis.