Complete resection of the caudate lobe of the liver: technique and results.

The caudate lobe of the liver is a frequent site of involvement by metastatic or primary liver tumours. This study describes the surgical anatomy and analyses the operative technique, results and postoperative morbidity of complete caudate lobectomy. The data represent a retrospective review of 21 consecutive complete caudate lobe resections performed over a 30-month period. The most common diagnosis was metastatic colorectal cancer (nine patients) and the most common procedure was extended left hepatic lobectomy with en bloc caudate lobectomy. Four patients underwent isolated complete caudate lobe resection. The median operating time was 5 h and the median blood loss was 1160 ml. The major complication rate was 38 per cent (nine major complications in eight patients) with 10 per cent mortality rate (two deaths). The median hospital stay was 11 days. This series demonstrates the feasibility of routine complete caudate lobe resection for tumours with general principles of liver resection. Isolated caudate lobectomy can be performed safely and the addition of caudate lobectomy to major liver resection does not add significantly to the morbidity or mortality of the procedure.