Surgical efficacy of benign tumor of liver in the caudate lobe

Abstract

Objective To evaluate the surgical efficacy of benign tumor of liver in the caudate lobe. Methods The clinical data of 112 patients with benign tumor of liver in the caudate lobe who were admitted to the Eastern Hepatobiliary Surgery Hospital from January 2003 to April 2014 were retrospectively analyzed. The left-sided approach, right-sided approach, bilateral approach, central anterior approach and retrograde caudate lobectomy were selected according to the location and size of the tumor. All the patients were followed up by outpatient examination and telephone interview up to October 2014. Results Of all the 112 patients who received complete resection of tumor, 33 patients received caudate lobectomy (22 by bilateral approach, 11 by left-sided approach) , 28 received left hemihepatectomy + caudate lobectomy (by left-sided approach) , 21 received mesohepatectomy + caudate lobectomy (by central anterior approach) , 19 received partial right hepatectomy + caudate lobectomy (by right-sided approach) , 11 received right hemihepatectomy + caudate lobectomy (9 by right-sided approach, 2 by retrograde caudate lobectomy) . During the operation, 72 patients received vascular inflow occlusion, 29 received vascular inflow occlusion combined with hepatic veins occlusion, 6 received total hepatic vascular exclusion and 5 did not receive vascular inflow occlusion. The operation time, mean time of vascular inflow occlusion, mean volume of intraoperative blood loss, cases of blood transfusion, mean volume of blood transfusion and duration of postoperative hospital stay were (192 ±69) minutes, 28 minutes (range, 0-94 minutes) , 590 mL (range, 100-12 000 mL) , 68, 600 mL (range, 200-10 000mL) and (8. 2 ±2. 7) days, respectively. Thirty-one patients had postoperative complications, including 21 with bile leakage, 7 with medium and above volume of pleural effusion, 2 with postoperative bleeding and 1 with hepatic failure. The complications were cured after symptomatic treatment. No patient died perioperatively. All the 112 patients were followed up for a median time of 12 months (range, 6-24 months) . All patients were survived well and without tumor recurrence during the follow-up. Conclusions Surgical treatment is an effective method for benign tumor of liver in the caudate lobe, with the good recovery of patients and definitive surgical efficacy. The key factors of surgical treatment include strictly following operative indication, rationally optimizing surgical approach, suitably selecting vascular inflow occlusion and the accurate operation. Key words: Liver neoplasms; Hepatic caudate lobe; Hepatectomy