Laparoscopic Caudate Lobectomy

Choon Hyuck David Kwon, Gyu-seong Choi, Jin Yong Choi, Seung Hwan Lee, Byung Gon Na, Kyo Won Lee, Won Tae Cho, Jong Man Kim, Jae Won Joh, Dong kyu Oh. Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Background

Caudate lobectomy has been considered as technically difficult because of the deep location of the caudate lobe and its proximity to great vessels. Laparoscopic caudate lobectomy was not feasible in patient with hepatocellular carcinoma (HCC) in the caudate lobe. The purpose of this study is to identify the safety and feasibility of laparoscopic caudate lobectomy.

Methods

Six consecutive patients with caudate hepatic tumor received laparoscopic caudate lobectomy at Samsung Medical Center from September 2006 to May 2014. Demographic data, intraoperative parameters, and postoperative outcomes were assessed.

Results

All procedures for these six patients with caudate hepatic tumors were completed with totally laparoscopic technique. Only one patient who had HCC in the Spiegel lobe underwent partial caudate lobectomy, and others underwent complete caudate lobectomy. The mean tumor size was 2.65 cm (range, 0.9-5.1 cm). The mean operative time was 382 min (range, 168–615 min) and all patients did not transfused red blood cells during procedures. The mean duration of hospital stay was 8 days (range 6-13 days). There was no perioperative complications and patient mortality in this series. The resected margins of the specimens were tumor free (R0 resections, range 0.1-1.2 cm). The mean follow-up period was 48 months (range, 4.9-85.6 months). All patients were alive, of whom, tumor recurrence occurred in four patients (67%). No patient died during the follow-up period.

Conclusions

Our experience demonstrated that laparoscopic caudate lobectomy is safe and feasible in selected patients with malignancy in caudate lobe.

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