Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 7, 2017; 23(41): 7433-7439
Published online Nov 7, 2017. doi: 10.3748/wjg.v23.i41.7433
Anatomic isolated caudate lobectomy: Is it possible to establish a standard surgical flow?
Yun Jin, Liang Wang, Yuan-Quan Yu, Dong-Er Zhou, Da-Ren Liu, Jun-Jie Yang, Shu-You Peng, Jiang-Tao Li
Yun Jin, Liang Wang, Yuan-Quan Yu, Dong-Er Zhou, Da-Ren Liu, Shu-You Peng, Jiang-Tao Li, Department of General Surgery, The Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
Jun-Jie Yang, Department of General Surgery, Xinchang People’s Hospital, Shaoxing 312500, Zhejiang Province, China
Author contributions: Peng SY and Li JT conceived and designed the study; Jin Y, Wang L, Yu YQ and Yang JJ performed the study; Jin Y and Yang JJ wrote the paper; Zhou DE, Liu DR, Peng SY and Li JT reviewed and edited the manuscript; All authors read and approved the manuscript.
Supported by the National Natural Science Foundation of China, No. 81570559 and No. 81272673; 2014 Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents.
Institutional review board statement: The study was reviewed and approved by the Second Affiliated Hospital Zhejiang University School of Medicine Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no conflict of interest related to this work.
Data sharing statement: Technical appendix, statistical code, and dataset available from the Jiang-Tao Li at zrljt@zju.edu.cn.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Jiang-Tao Li, MD, FACS, Department of General Surgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. zrljt@zju.edu.cn
Telephone: +86-571-89713727
Received: July 4, 2017
Peer-review started: July 5, 2017
First decision: July 28, 2017
Revised: August 10, 2017
Accepted: September 13, 2017
Article in press: September 13, 2017
Published online: November 7, 2017
Processing time: 123 Days and 12.6 Hours
Abstract
AIM

To establish the surgical flow for anatomic isolated caudate lobe resection.

METHODS

The study was approved by the ethics committee of the Second Affiliated Hospital Zhejiang University School of Medicine (SAHZU). From April 2004 to July 2014, 20 patients were enrolled who underwent anatomic isolated caudate lobectomy at SAHZU. Clinical and postoperative pathological data were analyzed.

RESULTS

Of the total 20 cases, 4 received isolated complete caudate lobectomy (20%) and 16 received isolated partial caudate lobectomy (80%). There were 4 cases with the left approach (4/20, 20%), 6 cases with the right approach (6/20, 30%), 7 cases with the bilateral combined approach (7/20, 35%), 3 cases with the anterior approach (3/20, 15%), and the hanging maneuver was also combined in 2 cases. The median tumor size was 5.5 cm (2-12 cm). The median intra-operative blood loss was 600 mL (200-5700 mL). The median intra-operative blood transfusion volume was 250 mL (0-2400 mL). The median operation time was 255 min (110-510 min). The median post-operative hospital stay was 14 d (7-30 d). The 1- and 3-year survival rates for malignant tumor were 88.9% and 49.4%, respectively.

CONCLUSION

Caudate lobectomy was a challenging procedure. It was demonstrated that anatomic isolated caudate lobectomy can be done safely and effectively.

Keywords: Caudate lobectomy; Surgical flow; Anatomic liver resection

Core tip: Caudate lobe resection is still a challenging procedure for the vast majority of surgeons because of the difficult anatomical location and intraoperative bleeding. According to prior experience, six steps were established and validated on the patient. Anatomic isolated caudate lobectomy can be done safely and effectively following the surgical flow.