Related Experiment Video
Updated: May 29, 2026
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
Caudate lobectomy (segmentectomy 1) (with video)
Yutaka Midorikawa1, Tadatoshi Takayama
1Department of Digestive Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamimachi, Itabashi-ku, Tokyo, 173-8610, Japan.
Insights
Hepatocellular carcinoma (HCC) in the caudate lobe can be safely removed using a high dorsal resection technique. This isolated caudate lobectomy preserves liver function and offers a potentially curative option for patients with liver disease.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Liver transplantation
Background:
- The caudate lobe's deep location poses surgical challenges.
- Hepatocellular carcinoma (HCC) in the caudate lobe requires specialized resection for curative intent.
- Standard liver resection is often precluded by poor liver function in HCC patients.
Purpose of the Study:
- To describe a high dorsal resection technique for isolated caudate lobectomy.
- To evaluate the safety and efficacy of this technique in HCC patients.
Main Methods:
- Anatomic isolated caudate lobectomy performed using a high dorsal resection approach.
- Caudate lobe dissection, boundary identification via counterstaining and tattooing.
- Liver transection along defined landmarks for complete caudate lobe removal.
Main Results:
- Complete removal of the caudate lobe achieved.
- Preservation of parenchyma in the major liver lobes.
- Maintained overall liver function post-procedure.
Conclusions:
- High dorsal resection is a safe and effective technique for isolated caudate lobectomy in HCC.
- This approach offers a potentially curative treatment for HCC in the caudate lobe, especially in patients with chronic liver disease.
Background:
The caudate lobe of the liver is located behind both major lobes and is surrounded by the inferior vena cava, three main hepatic veins, and the hepatic hilum. Despite a hard-to-approach anatomic location, isolated complete removal of the caudate lobe is recommended to improve curability in hepatocellular carcinoma (HCC). This is because most patients with HCC cannot undergo caudate lobectomy (segmentectomy 1) with resection of adjacent liver regions due to their poor liver function.
Methods:
We performed an anatomic isolated caudate lobectomy using a high dorsal resection technique in patients with HCC involving the paracaval portion of the liver. In this procedure, the caudate lobe is dissected, the boundary of the caudate lobe is identified using counterstaining and tattooing techniques, and the liver is transected along landmarks. The caudate lobe can be removed completely, without loss of the parenchyma of the major lobes, thereby preserving liver function.
Conclusions:
Given that most patients with HCC concurrently have chronic liver disease, those with HCC in the caudate lobe are good candidates for high dorsal resection of the liver, which is safe, potentially curative procedure.
