Surgical Treatment Of Tumor Originating From Caudate Lobe And20Cases Of Hepatic Caudate Lobectomy Report

[Objective]To summarize the clinical manifestation, imaging character, diagnosis and approach and method for caudate lobectomy, and explore the indication, the prevention of uncontrolled bleeding during caudate lobectomy and the postoperative complications.[Methods]All the patients with tumor originating from caudate lobe hospitalized in the department of General Surgery, Shandong Provincial Hospital from Jan,2009to Jan,2013.15cases underwent surgical procedure and obtain histopathological diagnosis. To analysis the clinical data from the clinical manifestation, imaging check, process of surgery, recovery and histopathological diagnosis.[Results]The analysis about the clinical data of20patients selected showed:The clinical manifestations of tumor originating from caudate lobe were stomachache, abdominal distension, uncomfortable of abdomen and so on. Some had discomfort of the back and some found the tumor when they were on physical examination. Among the20cases,14cases were found by B-mode ultrasonic diagnostic equipment and20were found the tumor originating from caudate lobe by CT and MRI. We had not used the anterior transhepatic approach. The tumor was resected by isolated or associated caudate lobectomy. The complications after operation were not serious. Histopathological diagnosis:hemangioma in8cases, malignant tumor in5cases.[Conclusion]Hemangioma and primary malignant tumors originating from caudate lobe are common. Because deep location of the caudate lobe, clinical manifestation of caudate lobe tumor appeared relatively late and the clinical symptom is no specific. Therefore, the detection, diagnosis of tumor originating from caudate lobe mainly depends on imaging. The caudate lobectomy is the major therapeutic method for it. According to the location, size of the tumor and the relationship of the tumor with other hepatic segments or vessels, different surgical methods were adopted, such as right posterior lobe+caudate lobectomy, single Spiegel lobectomy, and the left posterior lobe+caudate lobectomy by using the right approach, left approach or combined approach.The resection of caudate lobe has high risk, due to its special anatomical location. With the development of the anatomy of live, approach and method for caudate lobectomy, the resection of caudate lobe has not been restricted. In recent years, more and more domestic and foreign reports were involved in successful resection of caudate lobe. Exact preoperative evaluation, adopt reasonable surgical approach, intraoperative careful operation and postoperative intensive care are helpful to surgery. Caudate lobe resection is safe and feasible.