Retrograde Resection of Caudate Lobe of Liver

Abstract

D C l l p a t l t t t a o t r c t I m he caudate lobe is the dorsal portion of the liver lying osteriorly and embracing the retrohepatic inferior vena ava in a semicircumferential fashion. It lies between major ascular structures—the IVC posteriorly, the portal triads nferiorly, and the hepatic venous confluence superiorly. he surgical approach to caudate lobectomy is still not well stablished. Four basic approaches, including right-side, eft-side, combined, and anterior transhepatic, are used to erform caudate lobectomy. The technical approach of onventional caudate lobectomy, as described by Lerut, olonna, Nagasue, and their colleagues, emphasizes the mportance of proceeding by dividing the vascular attachents from the lobe to the IVC as a first step and following his with parenchyma transaction. In the procedure of hose classic ways, short hepatic veins (SHV) originating in audate lobe are divided and ligated at the initial stage. But hen the caudate neoplasm is closely adherent to or infilrating the IVC, or is too big to be turned from side to side, recluding the SHVs to be dissected, it is not suitable for onventional caudate lobectomy A new technique, retrorade caudate lobectomy, in which division and ligation of HV were carried out at the final stage of the operation nstead of at the initial stage, can be of great help in those ccasions. We designed and used this procedure successully in nine patients.