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Updated: Jan 23, 2026
07:22
Laparoscopic Left Hemihepatectomy Combined with Caudate Lobe Resection
Published on: April 11, 2025
745
Algorithm for Resecting Hepatocellular Carcinoma in the Caudate Lobe.
Tadatoshi Takayama1, Yutaka Midorikawa1, Tokio Higaki1
1Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
Annals of Surgery
|June 13, 2019
Summary
A new algorithm guides safe and effective resection of hepatocellular carcinoma (HCC) in the caudate lobe. This strategy demonstrated acceptable surgical safety and curability for patients with this challenging liver cancer.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Liver Cancer Treatment
Background:
- Resection of hepatocellular carcinoma (HCC) in the deep-seated caudate lobe is technically challenging.
- Existing guidelines for safe and curative caudate lobe HCC resection are lacking.
Purpose of the Study:
- To propose a novel algorithm for guiding the surgical resection of HCC in the caudate lobe.
- To improve safety and curability in caudate lobe HCC surgery.
Main Methods:
- Development of a resection algorithm based on tumor sublocation (Spiegel, process, caval), size, and patient liver function.
- Prioritization of partial resection for Spiegel or process HCC and total resection for caval HCC, adjusted for liver function.
Main Results:
- The algorithm was applied in 86.6% of 201 patients, with 174 undergoing resection (43 total, 158 partial).
- Low postoperative morbidity (3.0%) and zero mortality were observed.
- Five-year overall survival was 57.3% and recurrence-free survival was 15.3%, with surgical margin being a significant factor for survival.
Conclusions:
- An algorithm-guided approach offers an appropriate strategy for caudate lobe HCC resection.
- This method achieves acceptable surgical safety and curability for challenging liver cancer cases.
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