Re-recognition of caudal lobectomy in the laparoscopic era_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CAO Junqiu ,  WEI Yonggang

Division of Liver Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WEI Yonggang, Email: yourwyg@163.com

Keywords：

laparoscopy; hepatic caudate lobe resection; variation of caudate lobe; application

DOI：

10.7507/1007-9424.202305049

Video：

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The caudate lobe of the liver has always been regarded as the deepest segment, with most complicated anatomy. The surgeon’s understanding of the caudate lobe and its subsegments has undergone a complex and tortuous process. In recent years, the special view and fine anatomy of the caudate lobe in laparoscopic resection of caudate lobe of liver have been proved or challenged based on the traditional anatomical knowledge of the liver gross specimen, cast specimen and three-dimensional reconstruction. It is these validations and challenges that keep surgeons revising and restoring the caudate anatomy to its true form. This article will discuss these new ideas and describe the laparoscopic total caudate lobectomy in detail from the point of view of a laparoscopic surgeon.

Citation： CAO Junqiu, WEI Yonggang. Re-recognition of caudal lobectomy in the laparoscopic era. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(8): 900-904. doi: 10.7507/1007-9424.202305049 Copy

1.	Healey JE, Schroy PC. Anatomy of the biliary ducts within the human liver; analysis of the prevailing pattern of branchings and the major variations of the biliary ducts. AMA Arch Surg, 1953, 66(5): 599-616.
2.	Couinaud C, René L. Report of the work of the Academy of Surgery during 1980. Chirurgie, 1981, 107(1): 8-12.
3.	Filipponi F, Romagnoli P, Mosca F, et al. The dorsal sector of human liver: embryological, anatomical and clinical relevance. Hepatogastroenterology. 2000, 47(36): 1726-1731.
4.	Abdalla EK, Vauthey JN, Couinaud C. The caudate lobe of the liver: implications of embryology and anatomy for surgery. Surg Oncol Clin N Am, 2002, 11(4): 835-848.
5.	Kumon M. Anatomical study of the caudate lobe with special reference to portal venous and biliary branches using corrosion liver casts and clinical application. Liver Cancer, 2017, 6(2): 161-170.
6.	Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
7.	Wakabayashi G, Cherqui D, Geller DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg, 2015, 261(4): 619-629.
8.	Cai X. Laparoscopic liver resection: the current status and the future. Hepatobiliary Surg Nutr, 2018, 7(2): 98-104.
9.	Chai S, Zhao J, Zhang Y, et al. Arantius ligament suspension: a novel technique for retraction of the left lateral lobe liver during laparoscopic isolated caudate lobectomy. J Laparoendosc Adv Surg Tech A, 2018, 28(6): 740-744.
10.	Wakabayashi G, Cherqui D, Geller DA, et al. Laparoscopic hepatectomy is theoretically better than open hepatectomy: preparing for the 2nd International Consensus Conference on Laparoscopic Liver Resection. J Hepatobiliary Pancreat Sci, 2014, 21(10): 723-731.
11.	竜崇正, 赵明浩. 肝脏的外科解剖. 辽宁: 辽宁科学技术出版社, 2012: 1-172.
12.	Kogure K, Kuwano H, Yorifuji H, et al. The caudate processus hepatic vein: a boundary hepatic vein between the caudate lobe and the right liver. Ann Surg, 2008, 247(2): 288-293.
13.	Kogure K, Kuwano H, Fujimaki N, et al. Relation among portal segmentation, proper hepatic vein, and external notch of the caudate lobe in the human liver. Ann Surg, 2000, 231(2): 223-228.
14.	Zheng W, Ding ZH, Zhou J, et al. Anatomy of the retrohepatic tunnel in a Chinese population and its clinical application in liver surgery. Sci Rep, 2017, 7: 44977.
15.	Parikh M, Han HS, Cho JY, et al. Laparoscopic isolated caudate lobe resection. Sci Rep, 2021, 11(1): 4328.
16.	Edo H, Sekiguchi R, Edo N, et al. Evaluation of biliary anatomy in the caudate lobe using drip infusion cholangiography-computed tomography. Abdom Radiol (NY), 2019, 44(3): 886-893.
17.	Jassem W, Heaton ND, Rela M. Reducing bile leak following segmental liver transplantation: understanding biliary anatomy of the caudate lobe. Am J Transplant, 2008, 8(2): 271-274.
18.	Kitami M, Murakami G, Ko S, et al. Spiegel’s lobe bile ducts often drain into the right hepatic duct or its branches: study using drip-infusion cholangiography-computed tomography in 179 consecutive patients. World J Surg, 2004, 28(10): 1001-1006.
19.	Makki K, Chorasiya V, Srivastava A, et al. Analysis of caudate lobe biliary anatomy and its implications in living donor liver transplantation - a single centre prospective study. Transpl Int, 2018 May 2. doi: 10.1111/tri.13272. Online ahead of print.
20.	Aoki T, Murakami M, Koizumi T, et al. Three-dimensional virtual endoscopy for laparoscopic and thoracoscopic liver resection. J Am Coll Surg, 2015, 221(2): e21-e26.
21.	Hallet J, Gayet B, Tsung A, et al. Systematic review of the use of pre-operative simulation and navigation for hepatectomy: current status and future perspectives. J Hepatobiliary Pancreat Sci, 2015, 22(5): 353-362.
22.	Wei F, Jin L, Zhang C. Pure laparoscopic resection of a large caudate-lobe mass guided by three-dimensional reconstruction and green fluorescence navigation. Asian J Surg, 2023, 46(2): 1111-1112.
23.	Ding Z, Huang Y, Liu L, et al. Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection. Langenbecks Arch Surg, 2020, 405(6): 737-744.
24.	Peng Y, Liu F, Xu H, et al. Propensity score matching analysis for outcomes of laparoscopic versus open caudate lobectomy. ANZ J Surg, 2021, 91(4): E168-E173.
25.	Salloum C, Lahat E, Lim C, et al. Laparoscopic isolated resection of caudate lobe (segment 1): a safe and versatile technique. J Am Coll Surg, 2016, 222(5): e61-e66.
26.	Xu G, Tong J, Ji J, et al. Laparoscopic caudate lobectomy: a multicenter, propensity score-matched report of safety, feasibility, and early outcomes. Surg Endosc, 2021, 35(3): 1138-1147.
27.	Cappelle M, Aghayan DL, van der Poel MJ, et al. A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection. Langenbecks Arch Surg, 2020, 405(2): 181-189.
28.	Oh D, Kwon CH, Na BG, et al. Surgical techniques for totally laparoscopic caudate lobectomy. J Laparoendosc Adv Surg Tech A, 2016, 26(9): 689-692.
29.	Jiang Z, Du G, Wang X, et al. Laparoscopic versus open surgery for hepatic caudate lobectomy: a retrospective study. Surg Endosc, 2023, 37(2): 1149-1156.
30.	Ho KM, Han HS, Yoon YS, et al. Laparoscopic total caudate lobectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A, 2017, 27(10): 1074-1078.
31.	Sun T, Wang X, Cao L, et al. Laparoscopic liver resection for primary liver cancers originating in the paracaval portion of the caudate lobe: a preliminary retrospective analysis with 31 patients. Updates Surg, 2022, 74(2): 547-555.
32.	Jin B, Jiang Z, Hu S, et al. Surgical technique and clinical analysis of twelve cases of isolated laparoscopic resection of the hepatic caudate lobe. Biomed Res Int, 2018, 2018: 5848309. doi: 10.1155/2018/5848309.
33.	Molina V, Martín B, Moral A, et al. Laparoscopic liver resection of the Spiegel lobe by a left-sided approach preserving an accessory left hepatic artery. Surg Oncol, 2020, 33: 256.
34.	Dorovinis P, Machairas N, Kykalos S, et al. Safety and efficacy of laparoscopic caudate lobectomy: a systematic review. J Clin Med, 2021, 10(21): 4907.
35.	魏永刚, 张渝翰. 腹腔镜肝脏切除术的肝门血流阻断及断肝技巧. 中国普外基础与临床杂志, 2019, 26(2): 137-140.

1. Healey JE, Schroy PC. Anatomy of the biliary ducts within the human liver; analysis of the prevailing pattern of branchings and the major variations of the biliary ducts. AMA Arch Surg, 1953, 66(5): 599-616.
2. Couinaud C, René L. Report of the work of the Academy of Surgery during 1980. Chirurgie, 1981, 107(1): 8-12.
3. Filipponi F, Romagnoli P, Mosca F, et al. The dorsal sector of human liver: embryological, anatomical and clinical relevance. Hepatogastroenterology. 2000, 47(36): 1726-1731.
4. Abdalla EK, Vauthey JN, Couinaud C. The caudate lobe of the liver: implications of embryology and anatomy for surgery. Surg Oncol Clin N Am, 2002, 11(4): 835-848.
5. Kumon M. Anatomical study of the caudate lobe with special reference to portal venous and biliary branches using corrosion liver casts and clinical application. Liver Cancer, 2017, 6(2): 161-170.
6. Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: The Louisville Statement, 2008. Ann Surg, 2009, 250(5): 825-830.
7. Wakabayashi G, Cherqui D, Geller DA, et al. Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg, 2015, 261(4): 619-629.
8. Cai X. Laparoscopic liver resection: the current status and the future. Hepatobiliary Surg Nutr, 2018, 7(2): 98-104.
9. Chai S, Zhao J, Zhang Y, et al. Arantius ligament suspension: a novel technique for retraction of the left lateral lobe liver during laparoscopic isolated caudate lobectomy. J Laparoendosc Adv Surg Tech A, 2018, 28(6): 740-744.
10. Wakabayashi G, Cherqui D, Geller DA, et al. Laparoscopic hepatectomy is theoretically better than open hepatectomy: preparing for the 2nd International Consensus Conference on Laparoscopic Liver Resection. J Hepatobiliary Pancreat Sci, 2014, 21(10): 723-731.
11. 竜崇正, 赵明浩. 肝脏的外科解剖. 辽宁: 辽宁科学技术出版社, 2012: 1-172.
12. Kogure K, Kuwano H, Yorifuji H, et al. The caudate processus hepatic vein: a boundary hepatic vein between the caudate lobe and the right liver. Ann Surg, 2008, 247(2): 288-293.
13. Kogure K, Kuwano H, Fujimaki N, et al. Relation among portal segmentation, proper hepatic vein, and external notch of the caudate lobe in the human liver. Ann Surg, 2000, 231(2): 223-228.
14. Zheng W, Ding ZH, Zhou J, et al. Anatomy of the retrohepatic tunnel in a Chinese population and its clinical application in liver surgery. Sci Rep, 2017, 7: 44977.
15. Parikh M, Han HS, Cho JY, et al. Laparoscopic isolated caudate lobe resection. Sci Rep, 2021, 11(1): 4328.
16. Edo H, Sekiguchi R, Edo N, et al. Evaluation of biliary anatomy in the caudate lobe using drip infusion cholangiography-computed tomography. Abdom Radiol (NY), 2019, 44(3): 886-893.
17. Jassem W, Heaton ND, Rela M. Reducing bile leak following segmental liver transplantation: understanding biliary anatomy of the caudate lobe. Am J Transplant, 2008, 8(2): 271-274.
18. Kitami M, Murakami G, Ko S, et al. Spiegel’s lobe bile ducts often drain into the right hepatic duct or its branches: study using drip-infusion cholangiography-computed tomography in 179 consecutive patients. World J Surg, 2004, 28(10): 1001-1006.
19. Makki K, Chorasiya V, Srivastava A, et al. Analysis of caudate lobe biliary anatomy and its implications in living donor liver transplantation - a single centre prospective study. Transpl Int, 2018 May 2. doi: 10.1111/tri.13272. Online ahead of print.
20. Aoki T, Murakami M, Koizumi T, et al. Three-dimensional virtual endoscopy for laparoscopic and thoracoscopic liver resection. J Am Coll Surg, 2015, 221(2): e21-e26.
21. Hallet J, Gayet B, Tsung A, et al. Systematic review of the use of pre-operative simulation and navigation for hepatectomy: current status and future perspectives. J Hepatobiliary Pancreat Sci, 2015, 22(5): 353-362.
22. Wei F, Jin L, Zhang C. Pure laparoscopic resection of a large caudate-lobe mass guided by three-dimensional reconstruction and green fluorescence navigation. Asian J Surg, 2023, 46(2): 1111-1112.
23. Ding Z, Huang Y, Liu L, et al. Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection. Langenbecks Arch Surg, 2020, 405(6): 737-744.
24. Peng Y, Liu F, Xu H, et al. Propensity score matching analysis for outcomes of laparoscopic versus open caudate lobectomy. ANZ J Surg, 2021, 91(4): E168-E173.
25. Salloum C, Lahat E, Lim C, et al. Laparoscopic isolated resection of caudate lobe (segment 1): a safe and versatile technique. J Am Coll Surg, 2016, 222(5): e61-e66.
26. Xu G, Tong J, Ji J, et al. Laparoscopic caudate lobectomy: a multicenter, propensity score-matched report of safety, feasibility, and early outcomes. Surg Endosc, 2021, 35(3): 1138-1147.
27. Cappelle M, Aghayan DL, van der Poel MJ, et al. A multicenter cohort analysis of laparoscopic hepatic caudate lobe resection. Langenbecks Arch Surg, 2020, 405(2): 181-189.
28. Oh D, Kwon CH, Na BG, et al. Surgical techniques for totally laparoscopic caudate lobectomy. J Laparoendosc Adv Surg Tech A, 2016, 26(9): 689-692.
29. Jiang Z, Du G, Wang X, et al. Laparoscopic versus open surgery for hepatic caudate lobectomy: a retrospective study. Surg Endosc, 2023, 37(2): 1149-1156.
30. Ho KM, Han HS, Yoon YS, et al. Laparoscopic total caudate lobectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A, 2017, 27(10): 1074-1078.
31. Sun T, Wang X, Cao L, et al. Laparoscopic liver resection for primary liver cancers originating in the paracaval portion of the caudate lobe: a preliminary retrospective analysis with 31 patients. Updates Surg, 2022, 74(2): 547-555.
32. Jin B, Jiang Z, Hu S, et al. Surgical technique and clinical analysis of twelve cases of isolated laparoscopic resection of the hepatic caudate lobe. Biomed Res Int, 2018, 2018: 5848309. doi: 10.1155/2018/5848309.
33. Molina V, Martín B, Moral A, et al. Laparoscopic liver resection of the Spiegel lobe by a left-sided approach preserving an accessory left hepatic artery. Surg Oncol, 2020, 33: 256.
34. Dorovinis P, Machairas N, Kykalos S, et al. Safety and efficacy of laparoscopic caudate lobectomy: a systematic review. J Clin Med, 2021, 10(21): 4907.
35. 魏永刚, 张渝翰. 腹腔镜肝脏切除术的肝门血流阻断及断肝技巧. 中国普外基础与临床杂志, 2019, 26(2): 137-140.

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