Le resezioni del lobo caudato: note di tecnica e risultati chirurgici

Montemurro, Severino and Caliandro, Cosimo and Cartanese, Carmine and De Luca, Raffaele and Ruggieri, Eustachio and Rucci, Antonello and Sciscio, Vito (2009) Le resezioni del lobo caudato: note di tecnica e risultati chirurgici. Il giornale di chirurgia, 30 (5 Supp). p. 152. ISSN 1971-145X

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Background: Caudate lobe resection is a complex surgical procedure that requires a high level of technical skills and a deep knowledge of liver surgical anatomy. Materials and methods: From 1998 to 2008, 16 patients (8 females, 8 males), median age 60 years (44-77) underwent caudate lobe resection for 10 colorectal metastases; 4 hepatocarcinomas (HCC); 2 cholangiocarcinomas. Surgical procedures: 4 left hepatectomies with caudate lobectomy; 8 right hepatectomies with caudate lobectomy; 4 isolated caudate lobectomy. Pringle maneuver and a combined approach from right to left have been always used. In the 4 isolated caudate lobectomy, the control of supra and infrahepatic vena cava was accomplished by tourniquet occlusion. Results: Surgical procedure were R0 in 15 cases and R1 in one case. The median operative time was 320 min (± 20 min); estimated intraoperative bleeding was 900 ml (± 150 ml); morbility rate was 18,7% (1 anastomotic biliary fistula, 1 biliopleuric fistula; one acute kidney failure). Mortality rate was 6,25% (1 emoperitoneum). The median postoperative stay was 17,8 days (range 5-42). Median survival was 20,5, 36,1 and 7,3 months for colorectal metastases, HCC and cholangiocarcinomas, respectively. Discussion: Isolated or associated caudectomy is a feasible surgical technique. However, isolated resection of caudate lobe is more complex and technical demanding due to its deep location and close relationships with hepatic hilar structures and the inferior vena cava. Therefore, a deep knowledge of caudate lobe surgical anatomy and a combined from right to left approach are strongly required.

Item Type: Article
Uncontrolled Keywords: fegato, lobo caudato, resezione
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 617 Rami vari della medicina; Chirurgia
Depositing User: Nadia Del Gobbo
Date Deposited: 11 Feb 2016 16:07
Last Modified: 11 Feb 2016 16:07
URI: http://eprints.bice.rm.cnr.it/id/eprint/5938

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