Surgical outcomes of isolated caudate lobe resection: A single series of 19 patients

Background. Isolated caudate lobe resection is a complex surgical procedure that requires technical expertise and knowledge of the surgical anatomy. Methods. All consecutive patients who were operated on for isolated caudate lobe resections by the senior author were studied. En bloc resections with adjacent hepatic parenchyma (as part of extended hepatectomies) or partial resections of the caudate lobe were excluded. Follow-up was completed by outpatient evaluation and mail correspondence. Results. Nineteen patients met the inclusion criteria (6 male, 13 female). Mean age (±SD) was 52 (±3) years. Primary diagnoses were colorectal metastases, hemangioma, hepatocellular carcinoma, adenoma, and neuroendocrine metastases. Margins were negative in all but 1 patient. One patient needed inferior vena cava resection. Pringle's maneuver was used in 1 patient (5%). Mean (±SD) operative time was 211 (±15) minutes, and estimated blood loss was 760 (±150) mL. Median blood transfusion was 0 U (range, 0-4). Complications (bile leak) were seen in 1 patient (5%). Median length of stay was 7 days (range, 4-14). There were no perioperative deaths. Conclusions. Isolated caudate lobe resection is a feasible procedure that can be done with low morbidity/mortality. Sound surgical judgment and detailed knowledge of the caudate lobe anatomy are keys for a safe performance of this procedure.